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Post-Stroke Incontinence Linked to Higher Mortality Risk

Urinary dysfunction may reflect serious brain damage

TUESDAY, Dec. 19 (HealthDay News) -- Stroke patients who develop urinary incontinence symptoms due to impaired awareness are at much greater risk of mortality or the need for nursing home care than patients who do not develop incontinence, researchers report in the December issue of the Journal of the American Geriatrics Society.

Renate Pettersen, M.D., of the Ullevaal University Hospital in Oslo, Norway, and an associate conducted a prospective observational study to assess micturition dysfunction in first-time acute and recurrent stroke patients. Pre-morbid daily living activities, comorbidity, previous and existing urinary problems, stroke syndromes, post-stroke mobility and cognition were evaluated.

Of the 315 patients studied, 147 (46 percent) had pre-existing urinary dysfunction and 78 patients developed new symptoms. Those who developed urinary incontinence due to impaired awareness, rather than urgency/frequency, were at greater risk of mortality and nursing home care at three months (odds ratio, 27.5). Patients with poor mobility and partial or total anterior circulation stroke type were also at greater risk than other patients.

"New-onset post-stroke urinary incontinence with impaired awareness of bladder needs is a strong and independent risk factor for poor outcome at three months. This probably reflects more serious brain damage, affecting sustained attention and information processing. Valid clinical tools to detect such dysfunction in stroke victims are needed. Clinical classification of post-stroke urinary incontinence is likely to improve management," they conclude.

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