Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

Figures & data

Figure 1 Flow chart depicting the number of subjects with fecal incontinence referred to the study.

Table 1 Baseline characteristics of the subjects in each setting. The childbirth data refers to the number of women who had one or more vaginal deliveries

	Subjects living at home	Acute elderly care ward patients	Rehab elderly care ward patients	Nursing home subjects	Statistics
Mean age (years) (95%CI)	72.6 (69.3–75.9)	84.3 (81.8–86.7)	81.7 (78.9–84.5)	83.8 (80.9–86.7)
Males	11(37%)	12 (40%)	16 (53%)	14 (47%)
Females	19 (63%)	18 (60%)	14 (47%)	16 (53%)
Participation rates	40%	41%	58%	79%
Median
Barthel index of ADL (IQR)	16 (14–18)	3 (1–6)	5 (2–7)	5 (1–8)	X^2 = 53.09 DF = 3 P < 0.01
Median
MMSE score (IQR)	30 (29–30)	27 (22–28)	27 (24–29)	24 (19.5–27.5)	X^2 = 30.894 DF = 3 P < 0.01
Anorectal surgery	14 (46.7%)	4 (13.3%)	4 (13.3%)	1 (3.3%)	X^2 = 20.861 DF = 3 P < 0.01
Urogenital surgery	13 (43.3%)	5 (16.7%)	3 (10%)	3 (10%)	X^2 = 16.724 DF = 3 P< 0.01
Childbirth (% refers to women in the group)	19 (100%)	11 (61.1%)	11 (78.6%)	13 (81.3%)
Rectal examination
Yes	N/A	4 (13%)	4 (13%)	N/A
Declined	N/A	18 (60%)	21 (70%)	N/A
From medical records	6 (20%)	8 (27%)	5 (17%)	4 (13%)

Abbreviations: ADL, activities of daily living; DF, degrees of freedom; IQR, interquartile range; MMSE, Mini-Mental State Examination; N/A, not available.

Table 2 The prevalence of factors contributing to FI in the older adults studied in each of the settings

	Subjects living at home	Acute elderly care ward patients	Rehab elderly care ward patients	Nursing home subjects	Statistics
Fecal loading	6 (20%)	17 (57%)	19 (63%)	21 (70%)	X^2 = 18.012 DF = 3 P< 0.01
Functional disability	5 (17%)	25 (83%)	25 (83%)	20 (67%)	X^2 = 38.222 DF = 3 P< 0.01
Cognitive impairment	5 (17%)	13 (43%)	14 (47%)	26 (87%)	X^2 = 30.033 DF = 3 P< 0.01
Loose stools	11 (37%)	20 (67%)	17 (57%)	6 (20%)	X^2 = 13.086 DF = 3 P< 0.01
Anorectal incontinence	1 (3%)	2 (7%)	1 (3%)	0
Comorbidity	11 (37%)	11 (37%)	20 (67%)	14 (47%)	X^2 = 7.232 DF = 3 P> 0.05

Abbreviations: DF, degrees of freedom; FI, fecal incontinence.

Table 3 Comparison of the baseline characteristics of patients in relation to whether their FI had resolved or not when reviewed after 3 months

	FI still present	FI resolved	Deceased	P value
n	79 (66%)	19 (16%)	22 (18%)
Male	42 (53%)	2 (11%)	9 (41%)
Female	37 (47%)	17 (90%)	13 (59%)
Median
Barthel ADL at baseline (IQR)	6 (2–12)	13 (7–17)	1 (0–5)	< 0.01
Setting in which assessed at baseline
Own homes n = 30	21 (70%)	9 (30%)	0
Acute care wards n = 30	12 (40%)	5 (17%)	13 (43%)
Rehab wards n = 30	19 (63%)	5 (17%)	6 (20%)
Nursing homes n = 30	27 (90%)	0	3 (10%)
Contributory factors to FI at baseline. The percentages quoted for each variable below relates to the maximum number of subjects in that column.
Cognitive impairment	44 (56%)	1 (5%)	13 (59%)	< 0.01
Disability	47 (60%)	9 (47%)	19 (86%)	< 0.05
Loose stools	27 (34%)	13 (68%)	14 (64%)	< 0.01
Fecal loading	40 (51%)	9 (47%)	14 (64%)	> 0.05
Anorectal incontinence	2 (3%)	1 (5%)	1 (5%)
Comorbidity	36 (46%)	8 (42%)	12 (55%)	> 0.05

Abbreviations: ADL, activities of daily living; FI, fecal incontinence; IQR, interquartile range.