In Singapore, the prevalence of UI among community-dwelling older adults was reported as 3.5% in those aged 55 years, 4.8% in those aged 65 years, and 7.9% in those aged 75 years. Although UI is not a life threatening problem, the symptoms of incontinence can cause considerable impairment. A questionnaire like the International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form (ICIQ-UI SF) is the simplest form of screening for continence status in both the community and primary care settings.

INTRODUCTIONProlonged stay in acute hospitals increases the risk of hospital-acquired infections in older patients, and disrupts patient flow and access to care due to bed shortages. We aimed to investigate the factors associated with prolonged length of stay (pLOS) among older patients (aged ≥ 78 years) in a tertiary hospital, to identify the potentially modifiable risk factors that could direct interventions to reduce length of stay (LOS).

METHODSDuring a three-month period from January 2013 to March 2013, we identified 72 patients with pLOS (LOS ≥ 21 days) and compared their demographic and clinical variables with that of 281 randomly selected control patients (LOS < 21 days) using univariate and multivariate logistic regression analyses.

RESULTSThe mean age of the patients was 85.30 ± 5.34 years; 54% of them were female and 72% were of Chinese ethnicity. Logistic regression revealed the following significant factors for increased LOS: discharge to intermediate and long-term care services (odds ratio [OR] 9.22, 95% confidence interval [CI] 3.56-23.89; p < 0.001); increased severity of illness (OR 2.41, 95% CI 1.12-5.21; p = 0.025); and presence of caregiver stress (OR 3.85, 95% CI 1.67-8.91; p = 0.002).

CONCLUSIONPresence of caregiver stress and nursing home placement are potential modifiable risk factors of pLOS among older patients. Early identification and management of caregiver stress, as well as expediting discharge planning, may help to reduce the length of stay for this cohort.

Aged ; Aged, 80 and over ; Caregivers ; Cross Infection ; epidemiology ; Female ; Health Services Accessibility ; Humans ; Length of Stay ; Male ; Random Allocation ; Regression Analysis ; Risk Factors ; Severity of Illness Index ; Singapore ; Social Class ; Stress, Psychological ; Tertiary Care Centers