Risk Factors for Emergency Department Visits or Hospitalizations Among Older Adults With Urinary Incontinence in Home Health Care.

IF 1.1 4区医学 Q4 GERIATRICS & GERONTOLOGY

Journal of gerontological nursing Pub Date : 2025-06-01 Epub Date: 2025-04-24 DOI:10.3928/00989134-20250417-02

Danielle Scharp, Jiyoun Song, Mary Happel Palmer, Veronica Barcelona, Maxim Topaz

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引用次数: 0

Abstract

Purpose: To determine factors associated with emergency department (ED) visits or hospitalizations among older adults with urinary incontinence (UI) in home health care (HHC).

Method: We analyzed HHC episode data for adults aged ≥65 years with UI. Five clusters were identified a priori using hierarchical clustering of symptoms extracted from clinical notes using natural language processing. Chi-square tests and backward stepwise logistic regression identified cluster, sociodemographic, and clinical variables associated with outcomes.

Results: A total of 39,179 HHC episodes reflecting 29,981 patients were included. Episodes in the anxiety, all symptoms, dizziness-anxiety, and constipation-anxiety-dizziness clusters were more likely to result in ED visits/hospitalizations versus the no symptoms cluster. Episodes for Black and Hispanic patients had higher odds of these outcomes than White patients. Episodes for patients with skin ulcers and prior urinary tract infections had higher odds of these outcomes than those without these characteristics.

Conclusion: Older adults with UI require comprehensive care addressing complex factors contributing to ED visits/hospitalizations. [Journal of Gerontological Nursing, 51(6), 38-47.].

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在家庭保健中，急诊科就诊或住院的老年人尿失禁的危险因素。

目的：确定家庭保健（HHC）中老年尿失禁（UI）患者急诊（ED）就诊或住院的相关因素。方法：我们分析了年龄≥65岁的成人UI患者的HHC发作数据。使用自然语言处理从临床记录中提取的症状进行分层聚类，先验地确定了五个聚类。卡方检验和反向逐步逻辑回归确定了与结果相关的聚类、社会人口统计学和临床变量。结果：共纳入39,179次HHC发作，反映29,981例患者。与无症状组相比，焦虑组、所有症状组、头晕-焦虑组和便秘-焦虑-头晕组的发作更容易导致急诊科就诊/住院。黑人和西班牙裔患者的发作比白人患者有更高的几率出现这些结果。与没有这些特征的患者相比，有皮肤溃疡和既往尿路感染的患者发生这些结果的几率更高。结论：老年尿失尿患者需要综合护理，解决导致急诊科就诊/住院的复杂因素。老年护理杂志，xx(xx), xx-xx。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of gerontological nursing 医学-护理

CiteScore

2.00

自引率

7.70%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Gerontological Nursing is a monthly, peer-reviewed journal publishing clinically relevant original articles on the practice of gerontological nursing across the continuum of care in a variety of health care settings, for more than 40 years.