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

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.