Urinary Incontinence Linked to Poor Stroke Outcomes Regardless of Severity: Study
Urinary incontinence (UI) is a common complication in stroke patients, but its impact across the spectrum of stroke severity is not well understood. A recent study aimed to assess the association between UI and health outcomes in stroke patients of varying severity, filling a gap in the existing literature. This study was published in the journal BJU International by Fry C. and colleagues.
Despite advances in stroke care, understanding the influence of UI on stroke outcomes, especially in patients with milder strokes, remains limited. Identifying predictors of poor outcomes, such as UI, is crucial for improving patient care and resource allocation.
Data were prospectively collected from the Sentinel Stroke National Audit Programme, including 1593 men and 1591 women admitted to four UK hyperacute stroke units (HASUs) from 2014 to 2016. Patients were stratified based on stroke severity using the National Institutes of Health Stroke Scale (NIHSS) scores ranging from 0 to 42. Multivariable logistic regression analysis was performed to assess the relationship between UI and various health outcomes, adjusting for confounding factors.
Key Findings:
• Among patients with mild strokes (NIHSS scores of 0-4), those with UI had significantly higher risks of in-hospital mortality, disability at discharge, pneumonia, urinary tract infection, prolonged hospital stay, palliative care by discharge, and discharge to care home compared to those without UI.
• Similar associations were observed in patients with moderate strokes (NIHSS scores of 5-15), with UI patients being at greater risk for poor outcomes, except for palliative care and activity of daily living (ADL) support.
• In patients with the most severe strokes (NIHSS scores of 16-48), UI was still associated with poor outcomes, although the odds ratios decreased as stroke severity increased.
The study highlights UI as a significant predictor of poor short-term outcomes in stroke patients, irrespective of stroke severity. Healthcare professionals should consider UI as an indicator of increased risk and tailor interventions accordingly to improve patient outcomes. This research provides valuable insights for identifying at-risk individuals and implementing targeted interventions in stroke care.
Reference:
Fry, C. H., Fluck, A., Affley, B., Kakar, P., Sharma, P., Fluck, D., & Han, T. S. Urinary incontinence indicates mortality, disability, and infections in hospitalised stroke patients. BJU International,2024. https://doi.org/10.1111/bju.16320
