Study of the relationship between premorbid urinary incontinence and stroke functional outcome

Objective: To examine functional outcome in stroke patients with premorbid incontinence of urine. Method: Comparative study in stroke patients between premorbidly incontinent and continent groups. Both groups were subjected to structured interview, clinical examination and functional assessment at one week post stroke. Functional assessment was repeated six months later. Subjects: Eighty-six patients with first-time stroke younger than 80 years of age admitted to hospital, were divided into two groups according to their continence status. Outcome measure: The 20-point Barthel Index. Setting: Medical wards at North Staffordshire Teaching Hospitals. Results. Of 86 stroke patients (46 continent and 40 premorbidly incontinent), 19 died before six-month assessment, of whom 15 (79%) were premorbidly incontinent. Premorbid incontinence was the most significant variable predicting poor functional outcome (Barthel Index score <15) at six months, with a sensitivity of 82.6% and specificity of 86.4% and with age-corrected p-value of <0.001. Conclusions: This study shows a significant relationship between premorbid incontinence and functional outcome at six months. However, other causes that could have contributed to the premorbid incontinence were not excluded. This point needs to be considered in future studies, which should also examine whether premorbid incontinence per se reflects an underlying predisposition for stroke.