Demographic and clinical characteristics of inpatient stroke patients in Turkey.

Objectives: This study aims to assess the stroke rehabilitation facilities provided by university hospitals (UHs) and training and research hospitals (TRHs) and to evaluate the geographical disparities in stroke rehabilitation. Patients and methods: Between April 2013 and April 2014 a total of 1,529 stroke patients (817 males, 712 females; mean age: 61.7±14.0 years; range, 12 to 91 years) who were admitted to the physical medicine and rehabilitation clinics in 20 tertiary care centers were retrospectively analyzed. Demographic, regional and clinical characteristics, details of rehabilitation period, functional status, and complications were collected. Results: The median duration of stroke was five (range, 1 to 360) months. The ratio of the patients treated in the TRH in the Marmara region was 77%, but only 25% of the patients were living in the Marmara region. Duration of hospitalization was longer in the TRHs with a median of 28 days compared to those of UHs (median: 22 days) (p<0.0001). More than half of the patients (55%) were rehabilitated in the Marmara region. Time after stroke was the highest in the Southeast region with a median of 12 (range, 1 to 230) months and the lowest in the Aegean region with a median of four (range, 1 to 84) months. Conclusion: This study provides an insight into the situation of stroke rehabilitation settings and characteristics of stroke patients in Turkey. A standard method of patient evaluation and a registry system may provide data about the efficacy of stroke rehabilitation and may help to focus on the problems that hinder a better outcome.

Post-stroke lower urinary system dysfunction and its relation with functional and mental status: a multicenter cross-sectional study.

BACKGROUND: Review of the literature clearly reveals that little is known about the association between functional and mental status, and Lower Urinary Tract Dysfunction (LUTD) in patients with stroke. OBJECTIVE: The aim of this study was to assess functional and mental status in stroke patients and to identify possible associations with the prevalence, severity and bother of LUTD. MATERIAL AND METHODS: This study was designed as a cross-sectional study and included 260 stroke patients enrolled from six different hospitals in Turkey. The patients were questioned using the Danish Prostatic Symptom Score (DAN-PSS) Questionnaire to evaluate LUTD, and evaluated using the Modified Barthel Index (MBI), Incontinence Quality of Life Questionnaire (I-QoL), and the Mini Mental State Examination (MMSE). RESULTS: At least one LUTD finding was reported in 243 (93.5%) patients; the most commonly encountered complaint in these patients was nocturia (75.8%). The mean MBI, MMSE, and I-QoL scores were found to be significantly lower in LUTD (+) patients compared to LUTD (-) patients (p = 0.000, p = 0.005, and p < 0.01, respectively). Similarly all parameters (MBI, MMSE, and I-QoL scores) assessed were found to be significantly lower for patients with urinary incontinence than those without incontinence (p = 0.000, p = 0.000, and p < 0.01, respectively). CONCLUSION: LUTD is a common problem in patients with stroke. LUTD is associated with poorer cognitive and functional status and the quality of life in these patients. We, therefore, suggest that bladder dysfunction should not be overlooked during rehabilitation of stroke patients.

Cross-sectional study of urinary problems in adults with cerebral palsy: awareness and impact on the quality of life.

We aimed to assess the functional status, urinary problems, and awareness of these problems in adults with cerebral palsy (CP) and their relationship with the quality of life. One-hundred-seventeen adults with CP (53 women, 64 men) were included in this study. Subjects were asked to fill out a urological questionnaire which dealt with urinary symptoms, awareness of urinary problems, and pharmacological treatment they received. Subjects were also assessed with the Gross Motor Function Classification System (GMFCS), Functional Independence Measures (FIM), Functional Mobility Scale (FMS), and King's Health Questionnaire (KHQ). The mean age of the subjects was 25.3 ± 7.8 years. Of the patients, 83.8% were currently unemployed, 95.7% were single, and 96.5% were living with family. Of the patients, 20.5% had experienced frequency, 38.5% had nocturia, 48.7% had urgency, and 36.8% had urge urinary incontinence. Approximately 80% of the patients did not refer to physician due to urinary problems, and 60% of patients were not recorded history about urinary problem by any physician. Urge urinary incontinence was statistically more frequent in females than males (54.7 and 21.9%,respectively, p < 0.05).Female patients had significantly higher KHQ incontinence impact, role limitation, physical limitation, emotion, incontinence severity measures, and symptom severity subgroup scores than male patients (p < 0.05). Urge urinary incontinence was most frequent (65.4%) in spastic quadriplegic CP (p < 0.05). All functional status scores (GMFCS, FIM-toilet transfer, and FMSs) were worse in spastic quadriplegic patients than other topographical involvement of CP (p < 0.0125). Although the urinary problems are common in adult with CP, it is yet an overlooked condition that could affect quality of life. Therefore, health care professionals, patients, and their caregivers should be aware of the increased risk of urinary problems in these patients.