Risk factors for urinary incontinence following acute stroke: a Meta-analysis_West China Medical Journal

Authors：

LIN Yang ^1,2 , XIAO Jing ¹ ,  HE Li ¹

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, Sichuan 611730, P. R. China;

Corresponding?author：

HE Li, Email: heli2003new@126.com

Keywords：

Stroke; Acute stage; Urinary incontinence; Risk factors; Meta-analysis

DOI：

10.7507/1002-0179.201703255

Video：

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Objective To study the risk factors of urinary incontinence in acute stroke patients and provide scientific evidence for preventing and managing such complication. Methods A computerized literature search was performed on both English and Chinese databases including Embase, Medline, Wanfang Data, VIP, and CNKI from January 1990 to January 2017 based on such search strategies as literature review and manual retrieval. In addition, we tracked down the related reference lists. The RevMan 5.3 software was used for Meta-analysis. Categorical data were calculated by the pooled odds ratio (OR) values and 95% confidence intervals (CI), and numerical data were calculated by pooled mean difference (MD) and 95%CI. Results A total of 17 articles of controlled studies with 2 428 cases and 3 725 controls were included. According to the results of Meta-analysis, factors associated with urinary incontinence following acute stroke were age [MD=2.80, 95%CI (0.29, 5.30),P=0.03], female gender [OR=1.29, 95%CI (1.16, 1.45),P<0.000 01], diabetes [OR=1.40, 95%CI (1.13, 1.73),P=0.002], heart disease [OR=1.65, 95%CI (1.29, 2.13),P<0.000 1), former cerebrovascular disease [OR=1.43, 95%CI (1.21, 1.69),P<0.000 1), speech disorder [OR=4.20, 95%CI (3.45, 5.10),P<0.000 01], smoking [OR=0.68, 95%CI (0.50, 0.92),P=0.01]. Hypertension [OR=1.25, 95%CI (0.99, 1.58),P=0.06], left hemisphere involvement [OR=1.29, 95%CI (0.81, 2.06),P=0.29], and hemorrhagic stroke [OR=1.26, 95%CI (0.79, 2.03),P=0.33] were not correlated with urinary incontinence following acute stroke. Conclusions Older age, female gender, diabetes, heart disease, former cerebrovascular disease and speech disorder are risk factors associated with post-stroke urinary incontinence, while smoking lowers the potential risk. However, hypertension, hemorrhagic stroke and left hemisphere involvement do not significantly increase the risk of urinary incontinence following stroke.

Citation： LIN Yang, XIAO Jing, HE Li. Risk factors for urinary incontinence following acute stroke: a Meta-analysis. West China Medical Journal, 2017, 32(5): 665-673. doi: 10.7507/1002-0179.201703255 Copy

1.	?Brittain KR, Peet SM, Castleden CM. Stroke and incontinence. Stroke, 1998, 29(2): 524-528.
2.	Yanagawa Y, Yoshihara T, Kato H, et al. Significance of urinary incontinence, age, and consciousness level on arrival among patients with stroke. J Emerg Trauma Shock, 2013, 6(2): 83-86.
3.	王娟, 潘速躍, 王靜新, 等. 腦卒中后尿失禁近期預后的影響因素. 中國老年學雜志, 2015, 35(20): 5789-5791.
4.	Nakayama H, J?rgensen HS, Pedersen PM, et al. Prevalence and risk factors of incontinence after stroke. The Copenhagen Stroke Study. Stroke, 1997, 28(1): 58-62.
5.	Patel M, Coshall C, Rudd AG, et al. Natural history and effects on 2-year outcomes of urinary incontinence after stroke. Stroke, 2001, 32(1): 122-127.
6.	肖巖. 腦卒中繼發尿失禁與多項臨床因素的相關性. 中國臨床康復, 2003, 7(3): 421.
7.	楊水泉, 馬海生, 鄧之駒. 急性腦梗死后尿失禁與病灶部位、大小的關系. 廣東醫學, 2002, 23(1): 79-80.
8.	Gariballa SE. Potentially treatable causes of poor outcome in acute stroke patients with urinary incontinence. Acta Neurol Scand, 2003, 107(5): 336-340.
9.	Kolominsky-Rabas PL, Hilz MJ, Neundoerfer B, et al. Impact of urinary incontinence after stroke: results from a prospective population-based stroke register. Neurourol Urodyn, 2003, 22(4): 322-327.
10.	蘇雅茹, 王堅, 蔣雨平. 腦卒中后尿失禁發生率、預后及其危險因素的前瞻性研究. 中風與神經疾病雜志, 2004, 21(6): 518-520.
11.	蒲蜀湘, 高聰, 潘翠環. 急性腦卒中并發尿失禁的臨床分析. 中國康復, 2004, 19(2): 78-80.
12.	杜敢琴, 尚學蘭, 黃麗娜, 等. 腦卒中后尿失禁患者的相關危險因素. 山東醫藥, 2005, 45(1): 26-27.
13.	Edwards DF, Hahn M, Dromerick A. Post stroke urinary loss, incontinence and life satisfaction: when does post-stroke urinary loss become incontinence?. Neurourol Urodyn, 2006, 25(1): 39-45.
14.	Pettersen R, Saxby BK, Wyller TB. Poststroke urinary incontinence: one-year outcome and relationships with measures of attentiveness. J Am Geriatr Soc, 2007, 55(10): 1571-1577.
15.	Pettersen R, Haig Y, Nakstad PH, et al. Subtypes of urinary incontinence after stroke: relation to size and location of cerebrovascular damage. Age Ageing, 2008, 37(3): 324-327.
16.	羅世堅, 李振東, 徐曉華, 等. 卒中后尿失禁對卒中患者 1 年生存的影響. 中華腦血管病雜志: 電子版, 2009, 3(3): 114-120.
17.	蔡文智, 郭麗, 王麗, 等. 廣州市腦卒中住院患者尿失禁相關因素的調查研究. 護理學報, 2012, 19(12): 1-6.
18.	蔡靜. 某三甲醫院住院患者腦卒中后尿失禁的相關因素分析. 石家莊: 河北醫科大學, 2014: 1-18.
19.	Cai WZ, Juan W, Li W, et al. Prevalence and risk factors of urinary incontinence for post-stroke inpatients in southern China. Neurourol Urodyn, 2015, 34(3): 231-235.
20.	王娟, 王思平, 張曉梅, 等. 急性缺血性腦卒中后尿失禁危險因素的研究. 現代預防醫學, 2016, 43(19): 3624-3629.
21.	WHO Task Force on Stroke and Other Cerebrovascular Disorders. Stroke--1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke, 1994, 20(10): 51-52.
22.	Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA, 2000, 283(15): 2008-2012.
23.	王家良, 王濱有. 臨床流行病學. 3 版. 北京: 人民衛生出版社, 2008.

1. ?Brittain KR, Peet SM, Castleden CM. Stroke and incontinence. Stroke, 1998, 29(2): 524-528.
2. Yanagawa Y, Yoshihara T, Kato H, et al. Significance of urinary incontinence, age, and consciousness level on arrival among patients with stroke. J Emerg Trauma Shock, 2013, 6(2): 83-86.
3. 王娟, 潘速躍, 王靜新, 等. 腦卒中后尿失禁近期預后的影響因素. 中國老年學雜志, 2015, 35(20): 5789-5791.
4. Nakayama H, J?rgensen HS, Pedersen PM, et al. Prevalence and risk factors of incontinence after stroke. The Copenhagen Stroke Study. Stroke, 1997, 28(1): 58-62.
5. Patel M, Coshall C, Rudd AG, et al. Natural history and effects on 2-year outcomes of urinary incontinence after stroke. Stroke, 2001, 32(1): 122-127.
6. 肖巖. 腦卒中繼發尿失禁與多項臨床因素的相關性. 中國臨床康復, 2003, 7(3): 421.
7. 楊水泉, 馬海生, 鄧之駒. 急性腦梗死后尿失禁與病灶部位、大小的關系. 廣東醫學, 2002, 23(1): 79-80.
8. Gariballa SE. Potentially treatable causes of poor outcome in acute stroke patients with urinary incontinence. Acta Neurol Scand, 2003, 107(5): 336-340.
9. Kolominsky-Rabas PL, Hilz MJ, Neundoerfer B, et al. Impact of urinary incontinence after stroke: results from a prospective population-based stroke register. Neurourol Urodyn, 2003, 22(4): 322-327.
10. 蘇雅茹, 王堅, 蔣雨平. 腦卒中后尿失禁發生率、預后及其危險因素的前瞻性研究. 中風與神經疾病雜志, 2004, 21(6): 518-520.
11. 蒲蜀湘, 高聰, 潘翠環. 急性腦卒中并發尿失禁的臨床分析. 中國康復, 2004, 19(2): 78-80.
12. 杜敢琴, 尚學蘭, 黃麗娜, 等. 腦卒中后尿失禁患者的相關危險因素. 山東醫藥, 2005, 45(1): 26-27.
13. Edwards DF, Hahn M, Dromerick A. Post stroke urinary loss, incontinence and life satisfaction: when does post-stroke urinary loss become incontinence?. Neurourol Urodyn, 2006, 25(1): 39-45.
14. Pettersen R, Saxby BK, Wyller TB. Poststroke urinary incontinence: one-year outcome and relationships with measures of attentiveness. J Am Geriatr Soc, 2007, 55(10): 1571-1577.
15. Pettersen R, Haig Y, Nakstad PH, et al. Subtypes of urinary incontinence after stroke: relation to size and location of cerebrovascular damage. Age Ageing, 2008, 37(3): 324-327.
16. 羅世堅, 李振東, 徐曉華, 等. 卒中后尿失禁對卒中患者 1 年生存的影響. 中華腦血管病雜志: 電子版, 2009, 3(3): 114-120.
17. 蔡文智, 郭麗, 王麗, 等. 廣州市腦卒中住院患者尿失禁相關因素的調查研究. 護理學報, 2012, 19(12): 1-6.
18. 蔡靜. 某三甲醫院住院患者腦卒中后尿失禁的相關因素分析. 石家莊: 河北醫科大學, 2014: 1-18.
19. Cai WZ, Juan W, Li W, et al. Prevalence and risk factors of urinary incontinence for post-stroke inpatients in southern China. Neurourol Urodyn, 2015, 34(3): 231-235.
20. 王娟, 王思平, 張曉梅, 等. 急性缺血性腦卒中后尿失禁危險因素的研究. 現代預防醫學, 2016, 43(19): 3624-3629.
21. WHO Task Force on Stroke and Other Cerebrovascular Disorders. Stroke--1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke, 1994, 20(10): 51-52.
22. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA, 2000, 283(15): 2008-2012.
23. 王家良, 王濱有. 臨床流行病學. 3 版. 北京: 人民衛生出版社, 2008.

West China Medical Journal

Risk factors for urinary incontinence following acute stroke: a Meta-analysis

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