Department of Geriatric Medicine/Gerontology, Ohio University College of Osteopathic Medicine (OU-COM), Athens, OH 45701, USA.
J Am Med Dir Assoc. 2010 Oct;11(8):572-8. doi: 10.1016/j.jamda.2009.11.015. Epub 2010 Jun 26.
To assess the reliability of applying a radiographic scoring system in estimating the severity of stool retention (SR) in hospitalized older adults with constipation, and to identify risk factors associated with clinical constipation and SR scores.
Retrospective, case series study.
Southeast Ohio community hospital.
Adults 65 years or older with constipation or fecal impaction and abdominal radiographs available (N=122). Bowel obstruction was excluded.
Radiographs were independently scored by four readers twice, "5" being the most severe, for each quadrant of an abdominal film; possible total score was 0 to 20. Clinical constipation was defined as an average SR score of 13 or higher. Intra-class correlation was used to measure inter-rater agreement.
The overall inter-rater agreement on abdominal radiograph readings was 0.91, 95% confidence interval (CI)=0.88-0.93. Clinical constipation was associated with the use of statins and antimuscarinics by univariate logistic regression analysis. After adjusting for age, sex, residency, smoking history, oral laxatives, and self-reported constipation, the use of statins remained significantly associated with clinical constipation (OR=3.86, 95% CI=1.08-13.77, P=.036). Univariate linear regression analysis revealed that higher SR scores were associated with community residency, self-reported constipation, and the use of statins and antimuscarinics. After adjusting for the above confounders by multiple linear regression analyses, the use of antimuscarinics was independently associated with higher SR score (β=1.769, 95% CI=0.008-3.531, P=.049).
Abdominal radiography was reliable in assessing the severity of SR in older adults with constipation. The use of statins and antimuscarinics was associated with clinical constipation and greater SR.
评估在评估患有便秘的住院老年患者粪便潴留（SR）严重程度时应用放射学评分系统的可靠性，并确定与临床便秘和 SR 评分相关的危险因素。
回顾性病例系列研究。
俄亥俄州东南部社区医院。
年龄在 65 岁或以上、有便秘或粪便嵌塞且有腹部 X 光片的成年人（N=122）。排除了肠梗阻。
由四位读者独立对腹部 X 光片的每一个象限进行两次评分，“5”为最严重，可能的总分为 0 至 20 分。临床便秘的定义为 SR 评分平均为 13 或更高。使用组内相关系数来衡量评分者之间的一致性。
腹部 X 光片阅读的总体评分者间一致性为 0.91，95%置信区间（CI）为 0.88-0.93。单变量逻辑回归分析显示，使用他汀类药物和抗毒蕈碱药物与临床便秘有关。在调整年龄、性别、居住地、吸烟史、口服泻药和自我报告的便秘后，使用他汀类药物与临床便秘仍显著相关（OR=3.86，95%CI=1.08-13.77，P=.036）。单变量线性回归分析显示，更高的 SR 评分与社区居住、自我报告的便秘以及使用他汀类药物和抗毒蕈碱药物有关。在通过多元线性回归分析调整上述混杂因素后，使用抗毒蕈碱药物与更高的 SR 评分独立相关（β=1.769，95%CI=0.008-3.531，P=.049）。
腹部 X 光检查在评估便秘老年患者 SR 的严重程度方面具有可靠性。使用他汀类药物和抗毒蕈碱药物与临床便秘和更大的 SR 有关。
