Impact of urinary incontinence after stroke: Results from a prospective population-based stroke register

Authors

  • Peter L. Kolominsky-Rabas,

    Corresponding author
    1. Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
    • Unit for Stroke Research and Public Health Medicine, Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Bavaria, Germany.
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  • Max-Josef Hilz,

    1. Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
    2. Department of Neurology, New York University, New York, New York
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  • Bernhard Neundoerfer,

    1. Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
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  • Peter U. Heuschmann

    1. Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
    Current affiliation:
    1. Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
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Abstract

Aim

The purpose of this study was to investigate, in a community-based population, the frequency of stroke-related urinary incontinence (UI) and to analyse the long-term impact of UI on prognosis and institutional care.

Methods

Included were 752 acute stroke patients admitted consecutively during a 4-year period. We evaluated the UI by using the Barthel Index during the first 7 days and at 12-months follow-up.

Results

During the acute stage, the proportions of patients with full UI, partial UI, and no UI were 41%, 12%, and 47%, respectively (16%, 16%, and 68% at 12-months follow-up). A total of 45% of patients with UI at 12 months were institutionalised compared with 5% of patients without UI. In a multivariate logistic regression model, age, urinary incontinence at day 7, and severe disability at 12 months were demonstrated to be independent factors for a higher frequency of institutional care 12 months after stroke.

Conclusions

On admission in the acute stage, more than 50% of an unselected stroke population have UI. The proportion declines to one third of the surviving patients at 12 months. Stroke survivors who are incontinent in the acute stage have an fourfold higher risk to be institutionalised after 1 year. Neurourol. Urodynam. 22:322–327, 2003. © 2003 Wiley-Liss, Inc.

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