Current Incidence and Risk Factors of Fecal Incontinence After Acute Stroke Affecting Functionally Independent People
Lucente, Giuseppe (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Corral, Javier (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rodríguez-Esparragoza, Luis (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Castañer, Sara (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ortiz, Hector (Universitat Politècnica de Catalunya)
Piqueras, Anna (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Broto, Joaquim (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Hernández-Pérez, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domenech, Sira (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martínez-Piñeiro, Alicia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Serra Serra, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Almendrote, Míriam (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Parés, David (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Millán, Mònica (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)

Data:	2021
Resum:	Background: Previously published retrospective series show a high prevalence of fecal incontinence (FI) in stroke patients. We aimed to analyze in a prospective series the current incidence of FI in acute stroke in functionally independent patients and its evolution over time and the patient characteristics associated with the appearance of FI in acute stroke. Methods: We included consecutive patients with acute stroke admitted in our stroke unit who fulfilled the following inclusion criteria: a first episode of stroke, aged >18 years, with no previous functional dependency [modified Rankin Scale (mRS) ≤ 2] and without previous known FI. FI was assessed by a multidisciplinary trained team using dedicated questionnaires at 72 ± 24 h (acute phase) and at 90 ± 15 days (chronic phase). Demographic, medical history, clinical and stroke features, mortality, and mRS at 7 days were collected. Results: Three hundred fifty-nine (48. 3%) of 749 patients (mean age 65. 9 ± 10, 64% male, 84. 1% ischemic) fulfilled the inclusion criteria and were prospectively included during a 20-month period. FI was identified in 23 patients (6. 4%) at 72 ± 24 h and in 7 (1. 9%) at 90 days ± 15 days after stroke onset. FI was more frequent in hemorrhagic strokes (18 vs. 5%, p 0. 007) and in more severe strokes [median National Institute of Health Stroke Scale (NIHSS) 18 (14-22) vs. 5 (3-13), p < 0. 0001]. No differences were found regarding age, sex, vascular risk factors, or other comorbidities, or affected hemisphere. Patients with NIHSS ≥12 (AUC 0. 81, 95% CI 0. 71 to 0. 89) had a 17-fold increase for the risk of FI (OR 16. 9, IC 95% 4. 7-60. 1) adjusted for covariates. Conclusions: At present, the incidence of FI in acute stroke patients without previous functional dependency is lower than expected, with an association of a more severe and hemorrhagic stroke. Due to its impact on the quality of life, it is necessary to deepen the knowledge of the underlying mechanisms to address therapeutic strategies.
Ajuts:	Fundació la Marató de TV3 201718.10 Instituto de Salud Carlos III RD0016/0019/0020
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Fecal incontinence ; Acute stroke ; Incidence ; Acute ; Epidemiology
Publicat a:	Frontiers in neurology, Vol. 12 (november 2021) , ISSN 1664-2295

DOI: 10.3389/fneur.2021.755432
PMID: 34790163

8 p, 462.1 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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