Incontinence during and following hospitalisation: a prospective study of prevalence, incidence and association with clinical outcomes.

Incontinence is common in hospitalised older adults but few studies report new incidence during or following hospitalisation.

To describe prevalence and incidence of incontinence in older inpatients and associations with clinical outcomes.

Secondary analysis of prospectively collected data from consecutive consenting inpatients age 65 years and older on medical and surgical wards in four Australian public hospitals.

Participants self-reported urinary and faecal incontinence 2 weeks prior to admission, at hospital discharge and 30 days after discharge as part of comprehensive assessment by a trained research assistant. Outcomes were length of stay, facility discharge, 30-day readmission and 6-month mortality.

Analysis included 970 participants (mean age 76.7 years, 48.9% female). Urinary and/or faecal incontinence was self-reported in 310/970 (32.0%, [95% confidence interval (CI) 29.0-35.0]) participants 2 weeks before admission, 201/834 (24.1% [95% CI 21.2-27.2]) at discharge and 193/776 (24.9% [95% CI 21.9-28.1]) 30 days after discharge. Continence patterns were dynamic within the peri-hospital period. Of participants without pre-hospital incontinence, 74/567 (13.1% [95% CI 10.4-16.1) reported incontinence at discharge and 85/537 (15.8% [95% CI 12.8-19.2]) reported incontinence at 30 days follow-up. Median hospital stay was longer in participants with pre-hospital incontinence (7 vs. 6 days, P = 0.02) even in adjusted analyses and pre-hospital incontinence was significantly associated with mortality in unadjusted but not adjusted analyses.

Pre-hospital, hospital-acquired and new post-hospital incontinence are common in older inpatients. Better understanding of incontinence patterns may help target interventions to reduce this complication.

Age and ageing. 2023 Sep 01 [Epub]

Jill Campbell, Ruth Hubbard, Joan Ostaszkiewicz, Theresa Green, Fiona Coyer, Alison Mudge

National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Australia., Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, Australia., Aged Care Division, National Ageing Research Institute, Melbourne, Australia., School of Nursing, Midwifery & Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia., School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia., Internal Medicine and Aged Care Department, Royal Brisbane and Women's Hospital, Brisbane, Australia.

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