Urinary incontinence as a marker of higher mortality in home care patients

John, Gregor Raphaël; Gerstel, Eric; Jung, Michel; Daellenbach, Patrick Peter; Faltin, Daniel Ladislas; Petoud, Véronique; Zumwald, Catherine; Rutschmann, Olivier Thierry

doi:10.1111/bju.12359

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Title		Urinary incontinence as a marker of higher mortality in home care patients
Authors		John, Gregor Raphaël Gerstel, Eric Jung, Michel Daellenbach, Patrick Peter Faltin, Daniel Ladislas Petoud, Véronique Zumwald, Catherine Rutschmann, Olivier Thierry
Published in		BJU international. 2014, vol. 113, no. 1, p. 113-119
Abstract		OBJECTIVE: To evaluate urinary incontinence (UI) as a predictor of nursing home admission, hospitalization or death in patients receiving home care services. SUBJECTS/PATIENTS AND METHODS: 699 community-dwelling participants receiving home care services in Geneva were evaluated in fall 2004 using the Minimal Data Set-Home Care, a validated instrument that includes grading of UI. Data on death, hospitalization, and nursing home admission were collected through June 2007. The impact of UI on time dependant outcomes was analysed using survival analysis and multivariate regression Cox 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: UI was present in 193 participants (27.8%). After adjustment for confounding factors, UI was associated with longer hospital length of stay (+36.7 days, (CI95%: 1.2-72.3)) and greater mortality rate (HRa 1.6; CI95%: 1.1-2.6). Hazard ratio for death was 1.5 (CI95%:0.9-2.5) for participants complaining of one episode of urinary leakage per week at most, 2.0 (CI95%:1.2-3.5) for those presenting two or more episodes per week and 4.2 (CI95%:2.3-7.7; p for trend: <0.0001) for daily incontinence compared to continent participants. Institutionalization (HRa 1.1; CI95%: 0.6-2.2) and hospitalization rates (HRa 1.0; CI95%: 0.7-1.3) were not different between patients with or without UI. CONCLUSION: In a cohort of patients receiving home care services, UI is a strong predictor of length of hospitalization and mortality, increasing with UI severity
Identifiers		DOI: 10.1111/bju.12359 PMID: 24053316
Full text		Article (Published version) (676 Kb) - Limited access to UNIGE
Structures		Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires
Research group		Martinez De Tejada Begona (272)
Citation (ISO format)		JOHN, Gregor Raphaël et al. Urinary incontinence as a marker of higher mortality in home care patients. In: BJU international, 2014, vol. 113, n° 1, p. 113-119. doi: 10.1111/bju.12359 https://archive-ouverte.unige.ch/unige:33756