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Urinary incontinence as a marker of higher mortality in patients receiving home care services
Author(s) -
John Gregor,
Gerstel Eric,
Jung Michel,
Dällenbach Patrick,
Faltin Daniel,
Petoud Véronique,
Zumwald Catherine,
Rutschmann Olivier T.
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12359
Subject(s) - urinary incontinence , medicine , urinary system , urology
Objective To evaluate urinary incontinence ( UI ) as a predictor of nursing home admission, hospitalization or death in patients receiving home care services.Subjects and Methods A total of 699 community‐dwelling participants receiving home care services in G eneva were evaluated in A utumn 2004 using the M inimal D ata S et‐ H ome C are, a validated instrument that includes grading of UI . Data on death, hospitalization and nursing home admission were collected up until J une 2007. The impact of UI on time‐dependent outcomes was analysed using survival analysis and multivariate regression C ox models to adjust for age, gender, body mass index, cardiac failure, cognitive impairment, delirium, depression, disability, alcohol and tobacco use, self‐rated health, faecal incontinence and number of medications.Results We found that UI was present in 193 participants (27.8%). After adjustment for confounding factors, UI was associated with a longer length of hospital stay: +36.7 days, (95% confidence interval [ CI ]: 1.2–72.3) and a higher mortality rate (hazard ratio [ HR ] 1.6; 95% CI : 1.1–2.6). The HR for death was 1.5 (95% CI : 0.9–2.5) for participants complaining of one episode of urinary leakage per week at most, 2.0 (95% CI : 1.2–3.5) for those presenting with two or more episodes per week and 4.2 (95% CI : 2.3–7.7; P for trend: <0.001) for daily UI compared with participants without UI . Institutionalization ( HR 1.1; 95% CI : 0.6–2.2) and hospitalization rates ( HR 1.0; 95% CI : 0.7–1.3) were not different between patients with or without UI .Conclusion In a cohort of patients receiving home care services, UI was a strong predictor of length of hospital stay and mortality, increasing with UI severity.