Continence Status at Rehabilitation Admission Poststroke Does Not Predict 3- to 4-Year Institutionalization

Abstract

Poststroke urinary incontinence has been associated with death, poor functional outcome, and institutionalization. No studies have evaluated the impact of urinary incontinence on the placement of stroke survivors 3 to 4 years poststroke. Two hundred thirty first-time stroke survivors admitted consecutively to a stroke rehabilitation unit between August 1991 and August 1992 were screened for signs and symptoms of voiding dysfunction. Of these, 172 (74.7%) subjects were contacted and interviewed an average of 3.5 years poststroke. Of these, 10 (5.8%) subjects were institutionalized. Institutionalization at follow-up was not correlated with urinary incontinence at rehabilitation admission (χ² = 3.52, p = 0.08) but was correlated with urinary incontinence at follow-up (χ² = 6.77, p = 0.02, relative risk 5.75 [95% CI 1.26, 26.1]). Death of incontinent stroke survivors prior to follow-up may have weakened the correlation between urinary incontinence and institutionalization. However, incontinence was a major factor in the institutionalization decision in 6 of 6 (100%) subjects who were incontinent and remained so after stroke onset.

Keywords:

• bladder
• cerebrovascular disorders
• institutionalization
• nursing home
• urinary incontinence