Incontinence after brain injury: prevalence, outcome and multidisciplinary management on a neurological rehabilitation unit

Objective: To investigate the prevalence, outcome and multidisciplinary management of incontinence in patients with acquired brain injury. Design: Retrospective case notes review. Setting: Regional neurological rehabilitation unit. Subjects: Two hundred and thirty-eight patients with acquired brain injury. Main measures: Bladder and bowel subscores of the Barthel Index and Functional Independence Measure, number of multidisciplinary goals addressing bladder and bowel function. Results: Fifty per cent of patients (n= 112) had impaired bladder or bowel subscores on admission. Significant improvement was seen at discharge but 36% of patients (n = 77) still had some degree of impairment. Over 90% of patients were set multidisciplinary goals addressing self-care (n = 213) and mobility (n = 205) but only 3.5% (n = 8) were set multidisciplinary goals addressing bladder and bowel function. Conclusions: Incontinence was common in patients with brain injury on a neurological rehabilitation unit. Significant improvement was seen following rehabilitation. Bladder and bowel management was not well incorporated into the multidisciplinary management process.