Fecal incontinence in the institutionalized elderly: incidence, risk factors, and prognosis
Identifieur interne : 001A99 ( Main/Exploration ); précédent : 001A98; suivant : 001B00Fecal incontinence in the institutionalized elderly: incidence, risk factors, and prognosis
Auteurs : Philippe Chassagne [France] ; Isabelle Landrin [France] ; Christophe Neveu [France] ; Pierre Czernichow [France] ; Marc Bouaniche [France] ; Jean Doucet [France] ; Philippe Denis [France] ; Eric Bercoff [France]Source :
- The American Journal of Medicine [ 0002-9343 ] ; 1999.
Abstract
PURPOSE: This study was conducted to evaluate the incidence, identify the risk factors, and assess the prognosis of elderly institutionalized patients who develop fecal incontinence.PATIENTS AND METHODS: We enrolled 1,186 patients 60 years of age and older living in long-term care facilities who did not have fecal incontinence. We assessed their medical history, treatment, mobility, and cognitive function. Patients were followed up for 10 months to determine the incidence of fecal incontinence, defined as at least one involuntary loss of feces. Independent risk factors associated with fecal incontinence were identified using Cox proportional hazards models. The prognosis of incontinent patients was assessed by comparing their survival rate with that in the continent patients.RESULTS: Fecal incontinence occurred in 234 patients (20%), and was usually associated with acute diarrhea or fecal impaction. We identified five risk factors for the development of fecal incontinence: a history of urinary incontinence (rate ratio [RR]: 2.0, 95% confidence interval [CI] 1.5 to 2.6); neurological disease (RR: 1.9, 95% CI 1.0 to 3.4); poor mobility (RR: 1.7, 95% CI 1.2 to 2.4); severe cognitive decline (RR: 1.4, 95% CI 1.1 to 1.9); and age older than 70 years (RR: 1.7, 95% CI 1.0 to 2.8). Ten-month mortality in the 89 patients with long-term (≥8 days) incontinence was 26%, significantly greater than that observed in the continent group (6.7%) or in the 145 patients with transient incontinence (10%).CONCLUSIONS: Long-lasting or permanent fecal incontinence was associated with increased mortality, suggesting that this symptom is a marker of poor health in older patients. Actions that improve mobility might help prevent fecal incontinence in elderly patients.
Url:
DOI: 10.1016/S0002-9343(98)00407-0
Affiliations:
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xml:lang="en">PURPOSE: This study was conducted to evaluate the incidence, identify the risk factors, and assess the prognosis of elderly institutionalized patients who develop fecal incontinence.PATIENTS AND METHODS: We enrolled 1,186 patients 60 years of age and older living in long-term care facilities who did not have fecal incontinence. We assessed their medical history, treatment, mobility, and cognitive function. Patients were followed up for 10 months to determine the incidence of fecal incontinence, defined as at least one involuntary loss of feces. Independent risk factors associated with fecal incontinence were identified using Cox proportional hazards models. The prognosis of incontinent patients was assessed by comparing their survival rate with that in the continent patients.RESULTS: Fecal incontinence occurred in 234 patients (20%), and was usually associated with acute diarrhea or fecal impaction. We identified five risk factors for the development of fecal incontinence: a history of urinary incontinence (rate ratio [RR]: 2.0, 95% confidence interval [CI] 1.5 to 2.6); neurological disease (RR: 1.9, 95% CI 1.0 to 3.4); poor mobility (RR: 1.7, 95% CI 1.2 to 2.4); severe cognitive decline (RR: 1.4, 95% CI 1.1 to 1.9); and age older than 70 years (RR: 1.7, 95% CI 1.0 to 2.8). Ten-month mortality in the 89 patients with long-term (≥8 days) incontinence was 26%, significantly greater than that observed in the continent group (6.7%) or in the 145 patients with transient incontinence (10%).CONCLUSIONS: Long-lasting or permanent fecal incontinence was associated with increased mortality, suggesting that this symptom is a marker of poor health in older patients. Actions that improve mobility might help prevent fecal incontinence in elderly patients.</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Rouen</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Chassagne, Philippe" sort="Chassagne, Philippe" uniqKey="Chassagne P" first="Philippe" last="Chassagne">Philippe Chassagne</name></noRegion><name sortKey="Bercoff, Eric" sort="Bercoff, Eric" uniqKey="Bercoff E" first="Eric" last="Bercoff">Eric Bercoff</name><name sortKey="Bouaniche, Marc" sort="Bouaniche, Marc" uniqKey="Bouaniche M" first="Marc" last="Bouaniche">Marc Bouaniche</name><name sortKey="Czernichow, Pierre" sort="Czernichow, Pierre" uniqKey="Czernichow P" first="Pierre" last="Czernichow">Pierre Czernichow</name><name sortKey="Denis, Philippe" sort="Denis, Philippe" uniqKey="Denis P" first="Philippe" last="Denis">Philippe Denis</name><name sortKey="Doucet, Jean" sort="Doucet, Jean" uniqKey="Doucet J" first="Jean" last="Doucet">Jean Doucet</name><name sortKey="Landrin, Isabelle" sort="Landrin, Isabelle" uniqKey="Landrin I" first="Isabelle" last="Landrin">Isabelle Landrin</name><name sortKey="Neveu, Christophe" sort="Neveu, Christophe" uniqKey="Neveu C" first="Christophe" last="Neveu">Christophe Neveu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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