Urinary and Faecal Incontinence: Point Prevalence and Predictors in a University Hospital

Abstract

Incontinence is common and associated with adverse outcomes. There are insufficient point prevalence data for incontinence in hospitals. We evaluated the prevalence of urinary (UI) and faecal incontinence (FI) and their predictors among inpatients in an acute university hospital on a single day. Continence status was recorded using the modified Barthel Index (BI). Baseline characteristics, Clinical Frailty Scale (CFS) and ward type were recorded. In all, 435 patients were assessed, median age 72 ± 23 years and 53% were male. The median CFS score was 5 ± 3. The point prevalence of UI was 26% versus 11% for FI. While UI and FI increased with age, to 35.2% and 21.1% respectively for those ≥85, age was not an independent predictor. Incontinence also increased with frailty; CFS scores were independently associated with both UI (p = 0.006) and FI (p = 0.03), though baseline continence status was the strongest predictor. Patients on orthopaedic wards had the highest prevalence of incontinence. Continence assessments were available for only 11 (2%) patients. UI and FI are common conditions affecting inpatients; point prevalence increases with age and frailty status. Despite this, few patients receive comprehensive continence assessments. More awareness of its high prevalence is required to ensure incontinence is adequately managed in hospitals.

A multicenter study investigating SARS-CoV-2 in tertiary-care hospital wastewater. viral burden correlates with increasing hospitalized cases as well as hospital-associated transmissions and outbreaks

“…Rather, these sick and often elderly individuals are dependent on continence aids, adult diapers, sanitary pads and nursing cleanup; this results in fecal matter from these individuals being disposed into biohazard solid waste. Accordingly, wastewater-based sampling could miss between 10-20% of patients in general hospital patients ( Condon et al, 2019 ; Toba et al, 1996 ). This proportion is expected to be even higher in intensive care units where immobilization necessitated through ventilatory support further heightens toileting assistance requirements.…”

Wastewater Monitoring of SARS-CoV-2 from Acute Care Hospitals Identifies Nosocomial Transmission and Outbreaks

“…Rather, these sick and often elderly individuals are dependent on continence aids, adult diapers, sanitary pads and nursing cleanup; this results in fecal matter from these individuals being disposed into biohazard solid waste. Accordingly, wastewater-based sampling could miss between 10-20% of patients in general hospital patients[34, 35]. This proportion is expected to be even higher in ICU where immobilization necessitated through ventilatory support further heightens toileting assistance requirements.…”

Prevalence of frailty and pain in hospitalised adult patients in an acute hospital: a protocol for a point prevalence observational study

“…Given the focus of the study was on incontinence, associations with frailty were not fully explored, however, increased frailty scores were associated with both increased urinary and faecal incontinence. 29 Despite the difference in location (ie, New Zealand vs Ireland), these two studies suggest that approximately half of all inpatients within public hospitals are frail. However, the prevalence of frailty across all patients within an Australian hospital and within a private hospital setting has not previously been examined.…”

“…The prevalence of frailty was found to increase significantly with age and differences were found between admission types (eg, patients admitted to a medical specialty were frailer than those admitted to a surgical specialty 12 ). Condon et al 29 assessed frailty using the Clinical Frail Scale 30 and reported 52.2% prevalence of frailty in an acute university hospital in Ireland. Given the focus of the study was on incontinence, associations with frailty were not fully explored, however, increased frailty scores were associated with both increased urinary and faecal incontinence.…”