Deutekom M, Terra M P, Dobben A C, Dijkgraaf M G W, Baeten C G M I, Stoker J, Bossuyt P M M
Academic Medical Centre, Amsterdam, the Netherlands.
Colorectal Dis. 2005 May;7(3):263-9. doi: 10.1111/j.1463-1318.2005.00772.x.
Faecal incontinence is a problem that can have a major impact on the quality of life of those affected. Our aim was to relate the severity of faecal incontinence to the impact on several general health domains.
Patients from a prospective diagnostic cohort study, performed in 16 medical centres in the Netherlands, were invited to the study. The severity of incontinence was determined with the Vaizey score, which ranges from 0 (continent) to 24 (totally incontinent). Based on their Vaizey score, patients were assigned to one of five severity categories. All patients completed the EuroQol-5D instrument, which evaluates the existence of problems on five health domains: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
Data from 259 consecutive patients (25 male) could be analysed. Their mean age was 59 years (SD +/- 12). The mean duration of faecal incontinence was 8.1 years (SD +/- 8). The proportion of patients reporting problems rose significantly with increasing severity of faecal incontinence in the domains of usual activities (ranging from 36% in the least severe group to 71% in the most severe group (P < 0.001)), pain/discomfort (ranging from 35% to 60%; P = 0.025), and anxiety/depression (ranging from 23% to 49%; P = 0.037). No significant trends could be observed in the domains of mobility and self-care.
There exists a significant relation between severity of incontinence and frequency of reported problems in the domains of usual activities, pain/discomfort and anxiety/depression.
大便失禁是一个会对患者生活质量产生重大影响的问题。我们的目的是将大便失禁的严重程度与对几个总体健康领域的影响联系起来。
邀请了来自荷兰16个医疗中心进行的一项前瞻性诊断队列研究中的患者参与本研究。失禁严重程度通过韦齐评分来确定,评分范围从0(大便控制正常)到24(完全失禁)。根据韦齐评分,患者被分为五个严重程度类别之一。所有患者均完成了欧洲五维健康量表,该量表评估五个健康领域的问题存在情况:活动能力、自我护理、日常活动、疼痛/不适以及焦虑/抑郁。
对259例连续患者(25例男性)的数据进行了分析。他们的平均年龄为59岁(标准差±12)。大便失禁的平均持续时间为8.1年(标准差±8)。在日常活动领域(从最不严重组的36%到最严重组的71%(P < 0.001))、疼痛/不适领域(从35%到60%;P = 0.025)以及焦虑/抑郁领域(从23%到49%;P = 0.037),报告有问题的患者比例随着大便失禁严重程度的增加而显著上升。在活动能力和自我护理领域未观察到显著趋势。
失禁严重程度与日常活动、疼痛/不适和焦虑/抑郁领域报告问题的频率之间存在显著关联。