Urinary incontinence in the prediction of falls in hospitalized elderly

Concurrent cohort study where 221 elderly inpatients were followed from the date of admission until discharge, death or fall. The Kaplan-Meier methods, the incidence density and the Cox regression model were used for the survival analysis and the assessment of the association between the exposure variable and the other variables.

Results

Urinary incontinence was a strong predictor of falls in the surveyed elderly, and was associated with shorter time until the occurrence of event. Urinary incontinence, concomitant with gait and balance dysfunction and use of antipsychotics was associated with falls.

Conclusion

Measures to prevent the risk of falls specific to hospitalized elderly patients who have urinary incontinence are necessary.  

Aged; Inpatients; Urinary incontinence; Accidental falls; Survival analysis; Geriatric nursing

Time (in days)	Individuals	Censored events	Exposure to risk	Occurrence of event	Occurrence of event (proportion)	Survival (proportion)	Cumulative survival	Standard error of survival
Time (in days)	n	n	n	N	Occurrence of event (proportion)	Survival (proportion)	Cumulative survival	Standard error of survival
0 to 19	221	158	142	32	0.23	0.77	0.77	0.04
20 to 39	31	20	21	2	0.10	0.90	0.70	0.06
40 to 59	9	6	6	0	0.00	1.00	0.70	0.06
60 to 79	3	1	2	1	0.50	0.50	0.42	0.22
80 and more	1	1	1	0	0.00	1.00	0.42	0.22

Variables	Fall	People-time	*Incidence^() *() per 1000 people-time	RR	(CI 95%)	p value
Urinary incontinence
No	24	2609	9.20	1.00
Yes	11	176	62.50	6.80	(3.38–13.64)	<0.001
Age range (years)
≤ 69	16	82	19.5	1.00
≥ 70	19	139	13.7	1.42	(0.78–2.62)	0.251
Hypertension
No	2	441	4.53	1.00
Yes	33	2339	14.11	3.11	(0.75–12.92)	0.066^* * Fisher’s test
Diabetes
No	19	1914	9.95	1.00
Yes	16	866	18.47	1.86	(0.96–3.60)	0.061
Balance/gait
No dysfunction	7	1584	4.42	1.00
With dysfunction	28	1196	23.41	5.30	(2.32–12.09)	<0.001
Antihypertensive
No	2	397	5.04	1.00
Yes	33	2383	13.85	2.74	(0.66–11.41)	0.067^* * Fisher’s test
Hypoglycemic agents
No	13	1579	8.23	1.00
Yes	22	1201	18.32	2.22	(1.12–4.40)	0.018
Anxiolytics
No	29	2654	10.93	1.00
Yes	6	126	47.62	4.36	(1.84–10.30)	<0.001
Antipsychotics
No	30	2654	11.30	1.00
Yes	5	126	39.68	3.51	(1.38–8.89)	*0.019^ * Fisher’s test**
Anticonvulsants
No	32	2700	11.85	1.00
Yes	2	80	37.50	3.16	(0.99–10.12)	0.077^* * Fisher’s test

Variables	RR	(CI 95%)	p value
Age range (years)
≤ 69	1.00
≥ 70	1.51	(0.71 – 3.19)	0.274
Urinary incontinence
No	1.00
Yes	5.46	(2.48-12.01)	0.001
Balance/gait
With dysfunction	1.00
Without dysfunction	4.56	(1.81-11.45)	0.001
Use of antipsychotics
No	1.00
Yes	3.62	(1.33-7.04)	0.049

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Correspondence: Hellen Cristina de Almeida Abreu.  Universidade Federal de Mato Grosso.  Av. Fernando Corrêa da Costa, 2367 - Bairro Boa Esperança  CEP 78060-900 – Cuiabá, MT, Brazil

Brasil

Brasil

Urinary incontinence in the prediction of falls in hospitalized elderly* * Extracted from the dissertation "Incidência e fatores associados a quedas em idosos hospitalizados", Faculty of Nursing, Federal University of Mato Grosso, 2014

Incontinencia urinaria en la predicción de caídas en ancianos hospitalizados

Objective

Method

Results

Conclusion

Urinary incontinence in the prediction of falls in hospitalized elderly^* * Extracted from the dissertation "Incidência e fatores associados a quedas em idosos hospitalizados", Faculty of Nursing, Federal University of Mato Grosso, 2014