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, 潘速跃, 王静新, 等. 脑卒中后尿失禁近期预后的影响因素. 中国老年学杂志, 2015, 35(20): 5789-5791.
4.	Nakayama H, Jørgensen 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.	肖岩. 脑卒中继发尿失禁与多项临床因素的相关性. 中国临床康复, 2003, 7(3): 421.
7.	杨水泉, 马海生, 邓之驹. 急性脑梗死后尿失禁与病灶部位、大小的关系. 广东医学, 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.	苏雅茹, 王坚, 蒋雨平. 脑卒中后尿失禁发生率、预后及其危险因素的前瞻性研究. 中风与神经疾病杂志, 2004, 21(6): 518-520.
11.	蒲蜀湘, 高聪, 潘翠环. 急性脑卒中并发尿失禁的临床分析. 中国康复, 2004, 19(2): 78-80.
12.	杜敢琴, 尚学兰, 黄丽娜, 等. 脑卒中后尿失禁患者的相关危险因素. 山东医药, 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.	罗世坚, 李振东, 徐晓华, 等. 卒中后尿失禁对卒中患者 1 年生存的影响. 中华脑血管病杂志: 电子版, 2009, 3(3): 114-120.
17.	蔡文智, 郭丽, 王丽, 等. 广州市脑卒中住院患者尿失禁相关因素的调查研究. 护理学报, 2012, 19(12): 1-6.
18.	蔡静. 某三甲医院住院患者脑卒中后尿失禁的相关因素分析. 石家庄: 河北医科大学, 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, 张晓梅, 等. 急性缺血性脑卒中后尿失禁危险因素的研究. 现代预防医学, 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, 王滨有. 临床流行病学. 3 版. 北京: 人民卫生出版社, 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, 潘速跃, 王静新, 等. 脑卒中后尿失禁近期预后的影响因素. 中国老年学杂志, 2015, 35(20): 5789-5791.
4. Nakayama H, Jørgensen 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. 肖岩. 脑卒中继发尿失禁与多项临床因素的相关性. 中国临床康复, 2003, 7(3): 421.
7. 杨水泉, 马海生, 邓之驹. 急性脑梗死后尿失禁与病灶部位、大小的关系. 广东医学, 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. 苏雅茹, 王坚, 蒋雨平. 脑卒中后尿失禁发生率、预后及其危险因素的前瞻性研究. 中风与神经疾病杂志, 2004, 21(6): 518-520.
11. 蒲蜀湘, 高聪, 潘翠环. 急性脑卒中并发尿失禁的临床分析. 中国康复, 2004, 19(2): 78-80.
12. 杜敢琴, 尚学兰, 黄丽娜, 等. 脑卒中后尿失禁患者的相关危险因素. 山东医药, 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. 罗世坚, 李振东, 徐晓华, 等. 卒中后尿失禁对卒中患者 1 年生存的影响. 中华脑血管病杂志: 电子版, 2009, 3(3): 114-120.
17. 蔡文智, 郭丽, 王丽, 等. 广州市脑卒中住院患者尿失禁相关因素的调查研究. 护理学报, 2012, 19(12): 1-6.
18. 蔡静. 某三甲医院住院患者脑卒中后尿失禁的相关因素分析. 石家庄: 河北医科大学, 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, 张晓梅, 等. 急性缺血性脑卒中后尿失禁危险因素的研究. 现代预防医学, 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, 王滨有. 临床流行病学. 3 版. 北京: 人民卫生出版社, 2008.

West China Medical Journal

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

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