Biomedical subjects

Renate Pettersen

Publications and source records attributed to Renate Pettersen.

3 recordsLinked to original sources

PubMed2006

Prognostic significance of micturition disturbances after acute stroke.

OBJECTIVES: To investigate the prevalence, incidence, clinical types, and prognostic effect of micturition disturbances in acute stroke. DESIGN: Prospective observational study. SETTING: Geriatric department (stroke and rehabilitation unit) in a community hospital (acute phase); outpatient clinic, patients' own homes, or nursing homes (3 months follow-up). PARTICIPANTS: Three hundred fifteen patients (mean age 77) with acute first-ever or recurrent stroke consecutively admitted to the hospital stroke unit. MEASUREMENTS: Premorbid basic and instrumental activities of daily living (ADLs) and mental functioning; comorbidity; previous and actual micturition symptoms; stroke syndromes; medication use; and poststroke mobility, ADLs, and cognition. RESULTS: One hundred forty-seven patients (46%) had preexisting micturition disturbances (urinary incontinence (UI), n = 98; urgency/frequency, n = 37; voiding difficulties, n = 12). Seventy-eight developed new symptoms (UI, n = 65; urgency/frequency, n = 4; sustained retention, n = 9). There were two UI types: urge UI (n = 27) and UI with impaired awareness of bladder needs (IA UI, n = 38). In regression analyses, IA UI was the only micturition disturbance predicting mortality and need for nursing home care at 3 months (odds ratio (OR) = 27.5, 95% confidence interval (CI) = 7.0-108.2), together with poor mobility (OR = 8.2, 95% CI = 2.6-26.2), and partial or total anterior circulation stroke type (OR = 3.6, 95% CI = 1.4-9.0). CONCLUSION: New-onset poststroke UI with impaired awareness of bladder needs is a strong and independent risk factor for poor outcome at 3 months. This probably reflects more serious brain damage, affecting sustained attention and information processing. Valid clinical tools to detect such dysfunction in stroke victims are needed. Clinical classification of poststroke UI is likely to improve management.

Activities of Daily Living↗

PubMed2002

[Recurrent falls in the elderly].

BACKGROUND: Approximately 30% of community-dwelling elderly people in developed countries fall at least once each year. Although only 10% of falls lead to serious injuries, these represent a considerable share of all injury-related hospital admissions, with high mortality and morbidity and high health care costs. Early detection of persons at risk and effective intervention measures are needed. The article gives an overview of current knowledge in this field. METHODS: A limited literature search (1989-2001) and a telephone survey among all geriatric units in Norway. RESULTS: Recurrent falls are a multifactorial problem requiring a multifactorial intervention strategy at any care level and between levels. Exercise/balance training and hip protectors seem to be the most effective measures in preventing falls and fall injuries. INTERPRETATION: Feasible selection criteria, good cooperation routines and knowledge of local resources are important. Awareness of the problem is needed not only in geriatricians, but all health professionals caring for elderly patients.

Accidental Falls↗

PubMed2002

Prediction of long-term functional outcome after stroke rehabilitation.

OBJECTIVE: To find patient characteristics in the early post stroke phase that could predict three years functional outcome. DESIGN: Prospective study. SETTING: In-hospital rehabilitation department (admission and discharge). Outpatient department one and three years post stroke. SUBJECTS: One hundred and forty-two stroke patients (56% women), median age 75 years. MAIN OUTCOME MEASURES: Barthel Index (BI) score; BI score change; accommodation status; Rankin scale score; and Frenchay Activities Index (FAI) score, all registered three years post stroke. RESULTS: The percentages of patients still living at home after one and three years were 88% and 83%, respectively. Twenty per cent of the patients had deteriorated according to the BI after three years, mostly due to recurrent strokes (odds ratio (OR) 10.3; 95% confidence interval (CI) 3.0-35.5) and co-morbidity with other disabling disorders (OR 3.9; CI 1.1-13.5). Co-morbidity also emerged as an important risk factor for dependency according to BI score (OR 8.8; Cl 2.4-32.1) as well as for a poor FAI score (OR 4.9; CI 1.9-13.0). BI in the early phase was the strongest predictor for long-term functional outcome. Urinary incontinence emerged as a risk factor for nursing home placement after three years (OR 3.2; CI 0.9-11.3). Cognitive dysfunction was a risk factor for poor FAI scoring (OR 2.7; CI 1.0-7.0). CONCLUSIONS: After stroke rehabilitation, concomitant chronic disabling disorders and recurrent strokes seem to play an important role regarding dependency, handicap and long-term functional decline.

Aged↗