Continence Status as a Marker of Vulnerability in Hospitalised Older Adults in a Post-Acute Rehabilitation Unit
Bibliographic record
Abstract
Abstract Background Continence status is a critical yet often underrecognized factor in the care of older adults. Incontinence, both bladder and bowel, has been associated with increased frailty, more extended hospital stays, and a higher incidence of complications such as delirium. In this retrospective observational study, we aimed to explore the relationship between continence status and key outcomes, including length of stay, delirium, and living arrangements among older hospitalised adults. Methods Thirty patients admitted to a rehabilitation ward were evaluated for their continence status on admission and at discharge. Data on age, gender, living situation, delirium incidence, and hospital length of stay were collected. Kruskal-Wallis tests were used to assess differences in length of stay across continence categories, and chi-square tests were employed to evaluate associations with delirium. All analyses were conducted using R software. Results The average age (SD) was 83.3 (6.6) years, with a median (IQR) hospital length of stay of 56 (37.5) days. Bowel continence improved from 15 to 20 patients by discharge, while bladder continence improved slightly (12 to 13), though occasional incontinence increased. Patients who were fully continent had the shortest median hospital stays (48.5 days), while those with dual incontinence had the longest median (72.5 days). Delirium occurred exclusively in patients with both bowel and bladder incontinence (p = 0.0163). Additionally, continent patients were more likely to live alone versus those doubly incontinent (54.5% vs 38.5%), suggesting greater independence. Conclusion In this small cohort, incontinence was strongly associated with increased hospital length of stay and the occurrence of delirium. These findings highlight the importance of continence as a marker of vulnerability in older adults and support early continence assessment and intervention as part of comprehensive geriatric care. Larger studies are warranted to validate these trends and inform best practices in hospital-based continence management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".