Association between mental disorder and hospitalization outcomes in neurogenic bladder: a retrospective nationwide...

We examined the relationship between psychiatric comorbidities-namely depression, anxiety, and combined depression-anxiety-and hospitalization outcomes among patients diagnosed with neurogenic bladder. Using a large, nationally representative database, the study sought to generate evidence for refining clinical guidelines and improving patient management.

A retrospective study was performed using National Inpatient Sample (NIS) records from 2010-2019, identifying 676,826 adults with neurogenic bladder. Mental health comorbidities were classified through ICD-9/ICD-10 coding for depression (n = 125,654), anxiety (n = 77,730), and depression with anxiety (n = 34,330). Outcomes assessed included hospital length of stay, total charges, in-hospital mortality, and specific urological complications. Descriptive statistics and logistic regression analyses were applied, with adjustments for demographic and hospital-related variables.

Depression, anxiety, and depression-anxiety were found in 13.5%, 6.4%, and 5.1% of cases, respectively, with higher rates among older adults and women. Anxiety was associated with elevated risks of hydronephrosis (OR 1.420), urinary tract infections (OR 1.050), urinary stones (OR 1.511), and acute renal failure (OR 1.246), whereas the odds of cystitis were reduced (OR 0.636). Patients with both depression and anxiety exhibited comparable complication patterns, while depression alone showed no significant associations. Surprisingly, individuals with any of these psychiatric conditions had shorter median hospital stays (5 vs 6 days) and lower mortality (1.8-2.4% vs 3.7%).

Mental health comorbidities in patients with neurogenic bladder are linked to a nuanced spectrum of outcomes. Anxiety increases the risk of several urological complications yet may confer protective effects regarding mortality. These results underscore the importance of systematic psychological assessment and integrated multidisciplinary management in neurogenic bladder care.