Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain.
Epidemiology, IQVIA, Main Airport Centre, Unterschweinstiege 2-14 60549 Frankfurt am Main, Germany.
Ann Phys Rehabil Med. 2020 Nov;63(6):488-494. doi: 10.1016/j.rehab.2019.12.007. Epub 2020 Jan 22.
Investigating the short- and long-term health outcomes after stroke is a public health priority.
We aimed to analyse the incidence of urinary and fecal incontinence within 10 years of stroke in individuals followed in general practice in Germany.
Individuals who had received an initial stroke diagnosis at one of 1262 general practices in Germany between January 2006 and December 2015 were included (index date). Individuals without stroke were matched (1:1) to those with stroke based on propensity scores by using a "greedy" algorithm and logistic regression with sex, age, index year, and 17 comorbidities diagnosed in the 12 months before the index date. The main outcome of the study was the incidence of urinary and fecal incontinence within 10 years of stroke.
This study analysed data for 16,181 individuals with stroke and 16,181 without stroke. Within 10 years of the index date, 22% and 11% of men with and without stroke received a diagnosis of urinary incontinence (log-rank P<0.001); the prevalence of urinary incontinence was 34% in female stroke survivors and 17% in females with no history of stroke (log-rank P<0.001). The respective proportions of fecal incontinence were 5% and 2% for men (log-rank P<0.001) and 6% and 3% for women (log-rank P<0.001). Overall, stroke was positively associated with both urinary incontinence (men: hazard ratio [HR] 2.34, 95% confidence interval [CI] 2.10-2.61; women: HR 2.36, 95% CI 2.14-2.61) and fecal incontinence (men: HR 2.43, 95% CI 1.88-3.13; women: HR 2.60, 95% CI 1.98-3.41).
This study, using data from Germany, suggests that general practitioners should regularly screen for urinary and fecal incontinence in the decade following stroke.
调查中风后短期和长期的健康结果是公共卫生的重点。
我们旨在分析在德国普通诊所接受治疗的个体中风后 10 年内尿失禁和粪便失禁的发生率。
将在 2006 年 1 月至 2015 年 12 月期间在德国的 1262 家普通诊所之一接受初始中风诊断的个体纳入（索引日期）。基于性别、年龄、索引年份和索引日期前 12 个月内诊断的 17 种合并症，使用“贪婪”算法和逻辑回归，对没有中风的个体与有中风的个体进行 1:1 匹配。研究的主要结局是中风后 10 年内尿失禁和粪便失禁的发生率。
这项研究分析了 16181 名有中风和 16181 名无中风的个体的数据。在索引日期后的 10 年内，22%和 11%的有和无中风的男性接受了尿失禁的诊断（对数秩 P<0.001）；中风幸存者中女性尿失禁的患病率为 34%，无中风史的女性为 17%（对数秩 P<0.001）。男性分别为 5%和 2%，女性分别为 6%和 3%（对数秩 P<0.001）。总体而言，中风与尿失禁（男性：风险比[HR] 2.34，95%置信区间[CI] 2.10-2.61；女性：HR 2.36，95%CI 2.14-2.61）和粪便失禁（男性：HR 2.43，95%CI 1.88-3.13；女性：HR 2.60，95%CI 1.98-3.41）均呈正相关。
这项研究使用德国的数据表明，普通医生应在中风后 10 年内定期筛查尿失禁和粪便失禁。
