Documented incontinence after stroke: a secondary analysis of a cohort study. Reducing Ethnic and Geographic Inequities to Optimise New Zealand Stroke Care (REGIONS Care)

Aim: To estimate the prevalence of incontinence after stroke in Aotearoa New Zealand overall and by ethnicity, the associations between incontinence and subsequent mortality and living in residential care, and to estimate the health utilities in relation to continence.

Method: Secondary analysis of data from a prospective (1 May to 31 July 2018) cohort study (REGIONS Care study) of patients with a confirmed stroke admitted to New Zealand hospitals. Logistic and linear regression were used, and multivariate models were adjusted for age, sex, ethnicity, and stroke severity. The association between living in residential care, incontinence, and mobility was also assessed.

Results: There were 320/2,377 (13.5%) patients with documented incontinence during hospitalisation after stroke. Incontinence was not associated with ethnicity but was associated with increased mortality/living in residential care, at discharge, three, six and twelve months after stroke. Stroke survivors with independent mobility were more likely to live in residential care if incontinent. Health utility scores were lower at three, six and twelve months for those with incontinence after stroke.

Conclusion: This study likely underestimated incontinence prevalence after stroke, although incontinence was associated with increased mortality and probability of living in residential care.