As there have been no reports concerning the relationship between incontinence and disease severity in patients in the prehospital setting, a retrospective investigation examined this relationship using data from Shimoda Fire Department.

Patients who were transported by Shimoda Fire Department from January 2019 to December 2021 were investigated. The following details of the subjects were collected: age, sex, contents of incontinence, season of transportation, weather, wind speed, temperature, place of collapse, scene time, classification of disease, disease severity (as judged by a physician at a receiving hospital) and mortality rate at the initial treatment. The subjects were divided into groups based on the existence of incontinence at the scene or not (Incontinence [+] and Incontinence [-]). We compared the variables mentioned above between these groups.

There were 499 cases with incontinence and 8,241 cases without incontinence. There were no significant differences between the two groups with respect to weather and wind speed. The average age, percentage of male patients, percentage of cases in the winter season, rate of collapse at home, scene time, rate of endogenous disease, disease severity, and mortality rate in the Incontinence (+) group were significantly greater in comparison to the Incontinence (-) group, while the average temperature in the Incontinence (+) group was significantly lower than that in the Incontinence (-) group. Regarding the rates of incontinence of each disease, neurologic, infectious, endocrinal disease, dehydration, suffocation and cardiac arrest at the scene had more than twice the rate of incontinence in other conditions.

This is the first study to report that patients with incontinence at the scene tended to be older, showed a male predominance, severe disease, high mortality, and required a long scene time in comparison to patients without incontinence. Prehospital care providers should therefore check for incontinence when evaluating patients.