Clinical Characteristics of Stroke Occurring while Bathing.
BACKGROUND
Stroke can occur during any human activity. Although cardiac arrests or drowning accidents while bathing have been studied extensively, there are few studies focusing on stroke occurring while bathing. The objectives of this study were to evaluate the clinical characteristics of stroke occurring while bathing and the association between stroke and drowning accidents.


METHODS
Clinical data prospectively acquired between January 2011 and December 2015 on 1939 patients with stroke (1224 cerebral infarctions [CIs], 505 intracerebral hemorrhages [ICHs], and 210 subarachnoid hemorrhages [SAHs]) were reviewed to identify patients who sustained a stroke while bathing. The ratio of bathing-related strokes to strokes occurring during other activities was evaluated. Moreover, the demographics of these 2 groups were compared in each stroke type.


RESULTS
Among the 1939 patients, 78 (CI, 32; ICH, 28; and SAH, 18) sustained a stroke while bathing. The ratio of bathing to other activities in the SAH group was the highest (8.6%), followed by the ICH group (5.5%), whereas that in the CI group was the lowest (2.6%). Regardless of stroke type, only a minority of patients were found to have collapsed inside the bathtub.


CONCLUSIONS
The higher ratio of bathing in hemorrhagic strokes may indicate that there is a small risk of hemorrhagic stroke while bathing in vulnerable subjects. This retrospective study did not establish a causal relationship between bathing and stroke nor identify risk factors, which means that future prospective studies are warranted. The finding that the great majority of bathing-related stroke patients were found to have collapsed outside the bathtub suggests that the involvement of stroke in drowning accidents in the bathtub may be small.
Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan. Electronic address: inamasu@fujita-hu.ac.jp.
Joji
J
Inamasu
Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Masashi
M
Nakatsukasa
Department of Neurology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Takeo
T
Oshima
Department of Neurology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Kazuhiro
K
Tomiyasu
Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Keita
K
Mayanagi
Department of Neurology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Akira
A
Imai
D000368:Aged; D000369:Aged, 80 and over; D001494:Baths / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D002544:Cerebral Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors
Bathing; bathroom; drowning accident; stroke