Urinary incontinence in stroke patients after admission to a postacute inpatient rehabilitation program

Abstract

Objective: To determine the incidence of poststroke urinary incontinence in stroke patients admitted for a postacute inpatient rehabilitation program and its association with discharge destination.

Design: Cohort study of first-time stroke patients admitted for a postacute inpatient rehabilitation program from August 1994 to August 1997.

Setting: Rehabilitation center in the Netherlands.

Participants: Consecutive first-time stroke patients (n = 143).

Interventions: Not applicable.

Main outcome measures: Incidence rates calculated with observation time at risk in the denominator. Measures for outcome include the Modified Barthel Index (MBI) and the discharge destination.

Results: The incidence rate of urinary incontinence was 29/1000 persons per month (95% confidence interval [CI], 18-48/1000 persons monthly). For incontinent patients, the mean initial MBI score +/- standard deviation was 6.0 +/- 2.3 (range, 2-12); for continent patients, it was 11.5 +/- 9.8 (range, 2-18). This difference was statistically significant (t(139) = 2.12; p = .036; 95% CI for difference of the means, .379-10.84). Patients continent at time of discharge were more often discharged to their own homes than were incontinent patients (Fisher's exact test, p = .0006).

Conclusions: In this select cohort, the incidence of urinary incontinence was lower than that reported in the literature. An association was found between urinary incontinence and discharge destination and between urinary incontinence and functional ability on admission.