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The aim of this study was to determine the prevalence of fecal incontinence (FI) and its associated risk factors in acutely ill adult hospitalized patients.A cross-sectional design was used to collect data at 2 time points in 7 hospitals in the Midwestern United States. An investigator-developed tool was used by trained data collectors to identify pertinent patient characteristics, the presence of FI, and potential associated factors.The prevalence of FI in the 1083 patients assessed was 20% (n = 221). Prevalence rates from the 7 individual hospitals ranged from 16% to 30%. Medications were the most common associated factor (49%; n = 109), followed by neurologic diseases (40%; n = 89), and bowel motility disorders (30%; n = 67). The majority of patients with FI had stool consistency described as “loose unformed” (59%; n = 130) or “liquid” (25%; n = 55). Many patients had multiple potential risk factors for FI; 48% (n = 107) had 1 associated factor, 37% (n = 82) had 2 associated factors, and 8% (n = 18) had 3 or more associated factors. Age was associated with an increased likelihood of FI; the chances for FI increase 1.7% with each year of age. Unit type was also a significant associated with FI; patients managed in the intensive care unit were 78% more likely to have FI as compared to patients care for in a medical-rehabilitation unit.Fecal incontinence is a common problem in hospitalized adult patients. Previously identified risk factors were also found in our sample.