高血壓是中大腦動脈中風病人急性尿滯留之危險因子

邱泰樺¹、吳孟霓^2,3、陳浩瑋^2,4、阮雍順^1,2、陳妤甄^1,2

¹高雄醫學大學附設中和紀念醫院泌尿部；²高雄醫學大學 臨床醫學研究所；³高雄醫學大學附設中和紀念醫院神經部；⁴高雄市立大同醫院 泌尿科

Hypertension as a Risk Factor for Urinary Retention in the Acute Stage of the Middle Cerebral Artery Stroke

Tai-Hua Chiu¹, Meng-Ni Wu^2,3, Hao-Wei Chen^2,4, Yung-Shun Juan^1,2, Yu-Chen Chen^1,2

¹Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;

²Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Taiwan;

³Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;

⁴Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan

Purpose: Urinary retention is common after stroke, especially in patients with severe ischemic stroke. Early removal of urinary catheters in such patients is crucial in patients’ quality of life and may reduce catheter-associated complications. Therefore, the aim of our study is to identify the risk factors for middle cerebral artery (MCA) stroke with urinary retention requiring Foley catheter in the acute stage.

Materials and Methods: We retrospectively reviewed the medical record of the patients with acute MCA infarction requiring admission to neurological intensive care units between 2012 to 2019 in our tertiary hospital. Patients who had a Foley catheter already in place before stroke were excluded. All patients required Foley catheters after the diagnosis of acute MCA stroke. Multivariable logistic regression analysis was used to identify the risk factors associated with urinary retention requiring Foley catheter 7 days and 14 days after the MCA infarction.  

Results: A total of 104 patients was included. Among them, the placement of an indwelling Foley catheter was required in 75 (72%) and 65 (63%) patients 7 days and 14 days after acute stroke, respectively. Multivariable logistic regression analysis showed that hypertension was significantly associated with the requirement of indwelling Foley catheter 7 days and 14 days after the stroke (7 days: odds ratio (OR)=2.987; p = 0.026; 14 days: OR=3.047; p = 0.021), and that National Institutes of Health Stroke Scale (NIHSS) were significantly associated with the indwelling Foley catheter 14 days after the stroke (OR=1.096; p = 0.03).

Conclusions: In the present study, hypertension was found to be as a significant risk factor for the requirement of Foley catheter in the acute stage of MCA stroke. We should be aware of the urinary retention after the acute MCA stroke, especially in those patients with hypertension. Further longitudinal studies are warranted to clarify the relationship between hypertension and urinary retention in acute MCA infarction.