Urinary incontinence in stroke patients after admission to a postacute inpatient rehabilitation program.

Objective: To determine the incidence of poststroke urinary incontinence in stroke patients admitted for a postacute inpatient rehabilitation program and its association with discharge destination. Design: Cohort study of first-time stroke patients admitted for a postacute inpatient rehabilitation program from August 1994 to August 1997. Setting: Rehabilitation center in the Netherlands. Participants: Consecutive first-time stroke patients (n = 143). Interventions: Not applicable. Main Outcome Measures: Incidence rates calculated with observation time at risk in the denominator. Measures for outcome include the Modified Barthel Index (MBI) and the discharge destination. Results: The incidence rate of urinary incontinence was 29/1000 persons per month (95% confidence interval [CI], 18-48/1000 persons monthly). For inco ntinent patients, the mean initial MBI score +/- standard deviation was 6.0 +/- 2.3 (range, 2-12); for continent patients, it was 11.5 +/- 9.8 (range, 2-18). This difference was statistically significant (t(139) = 2.12; p = . 036; 95% CI for difference of the means, .379-10.84). Patients continent at time of discharge were more often discharged to their own homes than were incontinent patients (Fisher's exact test, p = .0006). Conclusions: In this select cohort, the incidence of urinary incontinence w as lower than that reported in the literature. An association was found bet ween urinary incontinence and discharge destination and between urinary inc ontinence and functional ability on admission.