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Incontinence after stroke in a rehabilitation setting

Outcome associations and predictive factors

From The Rehabilitation Hospital of Rhode Island (Dr. Ween), N. Smithfield, RI; Department of Neurology (Drs. Ween and Alexander), Braintree Hospital, Boston University School of Medicine, Boston, MA; University Hospital (Dr. D'Esposito), University of Pennsylvania, Philadelphia, PA; and Miriam Hospital (M. Roberts), Providence, RI.
Received December 12, 1995. Accepted in final form March 27, 1996.
Address correspondence and reprint requests to Dr. Jon Erik Ween, The Rehabilitation Hospital of Rhode Island, Department of Neurology, 116 Eddie Dowling Hwy., N. Smithfield, RI 02896.

Urinary incontinence (UI) after stroke is common and associated with overall poor functional outcomes.There is controversy regarding which factors contribute to incontinence after stroke and which factors may be predictive of recovery of continence. This study investigated consecutive stroke admissions to an inpatient rehabilitation hospital and evaluated the impact of several pre-selected factors on the presence of UI and its recovery. We also studied the impact of UI on outcome in terms of functional abilities with the Functional Independence Measure (FIM) and in terms of disposition. UI on admission was associated with severe functional impairment with large infarctions and was probably caused by general severity rather than specific impairment of neuromicturition control. Patients with less impairment (admission FIM >60) and small vessel strokes were likely to recover continence. UI on admission had a negative impact on outcome.

NEUROLOGY 1996;47: 659-663

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