Analysis of Subtypes of Urinary Incontinence in a Geriatric Outpatient Assessment of Older Women With Hip Fracture

Abstract

Purpose Urinary incontinence (UI) is known to be prevalent among older female hip fracture patients. Little is known about different subgroups of UI (stress, SUI; urgency, UUI; mixed, MUI) among these patients. Our aim was to identify factors associated with subtypes of UI. Methods 1,675 female patients aged ≥ 65 and treated for their first hip fracture in Seinäjoki Central Hospital, Finland, during 2007–2019, were included in a prospective cohort study. Of these women, 1,106 underwent comprehensive geriatric assessment (CGA), including questions on continence, at our geriatric outpatient clinic six-months post-fracture. A multivariable-adjusted multinomial logistic regression model was used. Results Of the 779 patients included in the present study, 360 (46%) were continent and 419 (54%) had UI six-months post-fracture. Of the women with UI, 117 (28%) had SUI, 183 (44%) had UUI, and 119 (28%) had MUI, respectively. Mean age of the patients was 82 ± 6,91. In multivariable analysis, depressive mood and poor mobility and functional ability were independently associated with SUI. Fecal incontinence (FI) and Body Mass Index (BMI) over 28 were independently associated with UUI. MUI shared the aforementioned factors with SUI and UUI and was independently associated with constipation. Conclusion MUI was associated with most factors, of which depressive mood and impaired mobility and poor functional ability were shared with SUI, and FI and higher BMI with UUI. MUI represents the most severe UI type in this patient population. CGA is key in managing and preventing UI in these vulnerable patients, regardless of UI subtype.