Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation?
Background: In this study, we aimed to investigate the incidence of fecal incontinence (FI) after severe acquired brain injuries (sABIs) and to determine whether this symptom can lead to an inability to return home after rehabilitation. Methods: This was a retrospective observational cohort study. I...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Neurology International |
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| Online Access: | https://www.mdpi.com/2035-8377/15/4/84 |
| _version_ | 1827573947724464128 |
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| author | Laura Pelizzari Elena Antoniono Donatella Giraudo Gianluca Ciardi Gianfranco Lamberti |
| author_facet | Laura Pelizzari Elena Antoniono Donatella Giraudo Gianluca Ciardi Gianfranco Lamberti |
| author_sort | Laura Pelizzari |
| collection | DOAJ |
| description | Background: In this study, we aimed to investigate the incidence of fecal incontinence (FI) after severe acquired brain injuries (sABIs) and to determine whether this symptom can lead to an inability to return home after rehabilitation. Methods: This was a retrospective observational cohort study. In total, 521 acute sABI inpatients were enrolled from the Department of Neurorehabilitation at an academic tertiary care hospital. Patients were divided into two groups, with and without FI, at the end of the rehabilitation phase. The primary and secondary endpoints were the incidence of persistent FI and any difference in the discharge destination. Results: Upon admission, new-onset FI was found in 443 (85%) patients, of which 38% had traumatic sABI. Moreover, 62.7% of all patients had FI upon admission. At discharge, 53.3% (264/495) of patients still had FI. Of these, 75.4% (199/264) had a Rancho Level of Cognitive Functioning Scale (LCFS) ≥3. A statistically significant correlation between FI at discharge and the presence of frontal lesions, autonomic crises, and increased LCFS scores was noted. Among the patients discharged to their homes, the proportion with persistent FI was lower (34% vs. 53.3). Conclusions: FI was significantly persistent after sABI, even after recovery from unconsciousness, and must be considered as a consequence of, rather than an independent risk factor for, unfavorable outcomes. |
| first_indexed | 2024-03-08T20:29:23Z |
| format | Article |
| id | doaj.art-d02b3517665c4b3d83b694d0ddb6b811 |
| institution | Directory Open Access Journal |
| issn | 2035-8377 |
| language | English |
| last_indexed | 2024-03-08T20:29:23Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Neurology International |
| spelling | doaj.art-d02b3517665c4b3d83b694d0ddb6b8112023-12-22T14:29:32ZengMDPI AGNeurology International2035-83772023-10-011541339135110.3390/neurolint15040084Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation?Laura Pelizzari0Elena Antoniono1Donatella Giraudo2Gianluca Ciardi3Gianfranco Lamberti4Department of Rehabilitative Medicine, AUSL Piacenza, 29017 Fiorenzuola d’Arda, PC, ItalyNeurorehabilitation Unit, AUSL CN1, 12045 Fossano, CN, ItalyDepartment of Urology, IRCCS San Raffaele Scientific Institute, 20127 Milano, MI, ItalyDepartment of Rehabilitative Medicine, AUSL Piacenza, 29017 Fiorenzuola d’Arda, PC, ItalyDepartment of Rehabilitative Medicine, AUSL Piacenza, 29017 Fiorenzuola d’Arda, PC, ItalyBackground: In this study, we aimed to investigate the incidence of fecal incontinence (FI) after severe acquired brain injuries (sABIs) and to determine whether this symptom can lead to an inability to return home after rehabilitation. Methods: This was a retrospective observational cohort study. In total, 521 acute sABI inpatients were enrolled from the Department of Neurorehabilitation at an academic tertiary care hospital. Patients were divided into two groups, with and without FI, at the end of the rehabilitation phase. The primary and secondary endpoints were the incidence of persistent FI and any difference in the discharge destination. Results: Upon admission, new-onset FI was found in 443 (85%) patients, of which 38% had traumatic sABI. Moreover, 62.7% of all patients had FI upon admission. At discharge, 53.3% (264/495) of patients still had FI. Of these, 75.4% (199/264) had a Rancho Level of Cognitive Functioning Scale (LCFS) ≥3. A statistically significant correlation between FI at discharge and the presence of frontal lesions, autonomic crises, and increased LCFS scores was noted. Among the patients discharged to their homes, the proportion with persistent FI was lower (34% vs. 53.3). Conclusions: FI was significantly persistent after sABI, even after recovery from unconsciousness, and must be considered as a consequence of, rather than an independent risk factor for, unfavorable outcomes.https://www.mdpi.com/2035-8377/15/4/84fecal incontinencebrain injuriesrehabilitation outcome |
| spellingShingle | Laura Pelizzari Elena Antoniono Donatella Giraudo Gianluca Ciardi Gianfranco Lamberti Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation? Neurology International fecal incontinence brain injuries rehabilitation outcome |
| title | Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation? |
| title_full | Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation? |
| title_fullStr | Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation? |
| title_full_unstemmed | Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation? |
| title_short | Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation? |
| title_sort | fecal incontinence after severe brain injury a barrier to discharge after inpatient rehabilitation |
| topic | fecal incontinence brain injuries rehabilitation outcome |
| url | https://www.mdpi.com/2035-8377/15/4/84 |
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