Parés David, Pera Miguel, Cartanyà Anna, Delgado-Aros Silvia, De Miguel Mario, Ortiz Hector, Grande Luis
Unidad de Cirugía Colorrectal, Hospital del Mar, Barcelona, España.
Cir Esp. 2009 Sep;86(3):154-8. doi: 10.1016/j.ciresp.2009.01.030. Epub 2009 Jun 18.
Faecal incontinence is a high prevalence disease in the general population. The aims of this study were to analyse which severity grading systems of faecal incontinence are used in Spain and to find out if there are differences in their use among specialists who manage these patients.
A postal questionnaire survey was sent to all hospitals of the National Health Service in Spain in order to study the attitudes and opinions of general surgery and gastroenterology specialists regarding the clinical evaluation of patients with faecal incontinence.
Ninety-nine questionnaires were returned fully completed (65 surgeons and 34 gastroenterologists). Only 41.8% of responders used a diary card systematically (46.8% surgeons vs. 32.3% gastroenterologists; p = 0.05). The Wexner score is the most widely grading system used in clinical practice (85.8% surgeons vs. 50% gastroenterologists; p = 0.01). The most relevant issues in the evaluation of these patients were considered: Type of faecal incontinence, frequency of leakage and quality of life. Finally, 85.5% of those questioned said that the universal acceptance of severity grading systems by all specialists would be an improvement, and 98.9% considered it useful to start a national plan of information regarding clinical evaluation of faecal incontinence in Spain.
There is variability in how faecal incontinence is evaluated among specialists in Spain.
大便失禁在普通人群中是一种高发性疾病。本研究的目的是分析西班牙使用哪些大便失禁严重程度分级系统,并了解在管理这些患者的专科医生中其使用情况是否存在差异。
向西班牙国家卫生服务体系的所有医院发送了一份邮政问卷调查,以研究普通外科和胃肠病学专科医生对大便失禁患者临床评估的态度和意见。
共收回99份完整填写的问卷(65名外科医生和34名胃肠病学家)。只有41.8%的受访者系统地使用了日记卡(外科医生为46.8%,胃肠病学家为32.3%;p = 0.05)。韦克斯纳评分是临床实践中使用最广泛的分级系统(外科医生为85.8%,胃肠病学家为50%;p = 0.01)。这些患者评估中最相关的问题被考虑在内:大便失禁类型、漏便频率和生活质量。最后,85.5%的受访者表示所有专科医生普遍接受严重程度分级系统将是一种改进,98.9%的受访者认为启动一项关于西班牙大便失禁临床评估的全国信息计划是有用的。
西班牙专科医生对大便失禁的评估方式存在差异。