Background: Understanding the factors associated with stroke complications, such as incontinence, provides insights into targeted assessments and therapies for at-risk groups. Screening for continence issues is essential among those with significant risk factors for incontinence, however there is little information available on the impact of these risk factors within an Australian acute hospital setting.
Aims: To examine the association of previously published risk factors for new-onset urinary incontinence (UI) and faecal incontinence (FI) after acute stroke.
Methods: A prospective intervention study on incontinence after stroke (Post-stroke Incontinence Rehabilitation with Adjunct Transcutaneous Electric Stimulation; PIRATES) was conducted. Included were 652 inpatients admitted consecutively to the acute stroke unit of a Comprehensive Stroke Centre (CSC) in Melbourne during a 15-month period beginning 1 May 2021. Univariate analyses on age, sex, stroke severity, premorbid disability, type of stroke, and anatomical location of stroke were conducted to explore unadjusted associations with UI and FI. Logistic and stepwise regression were used to perform multivariate analysis and build iterative models.
Results: Four hundred eighteen inpatients had acute stroke with no premorbid incontinence. Within the first 7 days after acute stroke, 107 had UI and 103 had FI. Significant factors associated with increased risk of new-onset UI and FI were age, stroke severity, premorbid disability, and having intraventricular haemorrhage. Females were more likely to have new-onset UI after acute stroke than males. Lobar haemorrhagic strokes were associated with higher risk of new-onset FI after acute stroke.
Conclusion: Continence assessment and care after acute stroke are more likely to be needed by those who had a severe stroke, intraventricular haemorrhage, greater premorbid disability, and are of advanced age. Findings suggest that inpatients with these risk factors may warrant specialist nursing care for continence issues.