Aims: Incontinence is common in hospitalised older adults but few studies report new incidence during or following hospitalisation. This study aimed to describe prevalence and incidence of incontinence in older inpatients and associations with clinical outcomes.
Methods: Secondary analysis of prospective data from inpatients age 65 years and older on medical and surgical wards in four Australian public hospitals. Participants self-reported urinary and faecal incontinence two weeks prior to admission, at hospital discharge and 30 days later as part of comprehensive assessment by a trained research assistant. Outcomes were length of stay, institutional discharge, 30-day readmission and six-month mortality.
Results: 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% CI 29.0-35.0]) participants two 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 later. Hospital-acquired incontinence was reported at discharge by 74/567 (13.1% [95% CI 10.4-16.1]) participants who were continent prior to admission, and persistent hospital-acquired incontinence at 30 days by 85/537 (15.8% [CI 12.8-19.2]) previously continent participants. Continence patterns were dynamic within the peri-hospital period. Hospital stay was longer in participants with hospital-acquired incontinence (median 7 days [IQR 5 to 10] versus 6 days [IQR 4 to 9], p=0.05) and they had higher risk of institutional discharge; this association was attenuated in adjusted analysis.
Conclusion: Prevalent, hospital-acquired and persistent hospital-acquired incontinence are common in older inpatients. Better understanding of hospital-acquired incontinence may help target interventions to reduce this complication.