Risk of stroke in first-ever acute urinary retention: A 10-year population-based study

Objective To examine the 10-year risk of stroke among patients with acute urinary retention (AUR) in Taiwan, using a population-based dataset. Methods This retrospective cohort study included 38,433 patients aged > 50 years with AUR, with or without catheterization, and 38,433 matched patients without AUR (controls) sourced from the Longitudinal Health Insurance Database from 2001 to 2010. Cox proportional hazards regression was used to evaluate the association between AUR and the risk of stroke during the subsequent 10-year follow-up period, after adjusting for sociodemographic characteristics, hypertension, diabetes, hyperlipidemia, coronary heart disease, and urinary tract infection. Results Of the 38,433 patients with AUR, 2805 (7.3%) had strokes during the follow-up period compared with 1077 (2.8%) controls (crude hazard ratio, 2.69; 95% confidence interval, 2.5–2.88). After adjusting for potential confounders, risk of stroke was increased in patients with AUR (hazard ratio, 2.36; 95% confidence interval, 2.19–2.53). There was a significant difference in the 10-year stroke-free survival rate between the patients with and without AUR (p < 0.001, log-rank test). In total, 26.77% of the patients with AUR who experienced a stroke during the 10-year follow-up period had ischemic stroke, while others had hemorrhagic stroke. Conclusion There was significant difference in the risk of stroke between patients with and without AUR. Preventive measures should be taken for patients with AUR, which may be associated with an increased risk of subsequent stroke. Large-scale population-based studies in other countries and regions are recommended.