Risk factors for hospital-acquired incontinence in elderly female hip fracture patients.
BACKGROUND
The objective of this study was to estimate the incidence of, and identify risk factors for, incontinence in female hip fracture patients. The study was a secondary analysis of data abstracted from medical records in hospitals in Pennsylvania, Texas, New Jersey, and Virginia.


METHODS
The study included women aged 60 years and older who were admitted to one of the study hospitals with hip fracture. Measurements included incontinence at discharge as recorded in the medical records, demographic information, cognitive and functional status, and two measures of severity of illness (Charlson Comorbidity Index and Sickness at Admission Scale score).


RESULTS
Data from 6516 women were analyzed. Twenty-one percent (n = 1365) became incontinent during hospitalization. After adjusting for confounders (i.e., age, race, malnutrition, comorbidity, and severity of illness), admission from a nursing home or other long-term care facility (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.29-2.19), confusion (OR 3.44, 95% CI 2.79-4.24), use of a wheelchair or device for walking (OR 1.53, 95% CI 1.29-1.83), and prefracture dependence on others for ambulation (OR 2.51, 95% CI 1.64-3.85) significantly increased the odds of developing incontinence during hospitalization.


CONCLUSIONS
Hospital-acquired incontinence affects 21% of female hip fracture patients. Certain easily identifiable patient characteristics place female hip fracture patients at high risk. Interventions to increase staff awareness of this vulnerable population need to be tested to minimize the incidence of hospital-acquired incontinence.
Palmer
Mary H
MH
School of Nursing, University of North Carolina, Chapel Hill, NC 27599, USA. mhpalmer@email.unc.edu
Baumgarten
Mona
M
Langenberg
Patricia
P
Carson
Jeffrey L
JL
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008134:Long-Term Care; D008875:Middle Aged; D009735:Nursing Homes; D010343:Patient Admission; D011237:Predictive Value of Tests; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology*; D016387:Women's Health