Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
Neuromodulation. 2020 Dec;23(8):1158-1163. doi: 10.1111/ner.13249. Epub 2020 Aug 17.
To evaluate changes in self-reported depression after treatment of fecal incontinence (FI) with sacral neuromodulation.
This is a subanalysis of data collected from March 2016 to October 2017 for an Institutional Review Board-approved retrospective cohort study. Demographic information, medical history, psychiatric comorbidities, and the Patient-Reported Outcomes Measurement Information System item bank t-scores were extracted from the electronic medical record. The differences in t-scores were compared with a two-sided paired t-test, and a p value <0.05 was considered statistically significant.
Of the cohort (n = 24), most were Caucasian (88%), female (92%), nonsmokers (92%). Median age was 63.5 years (interquartile range 57.5-71.0 years) and median body mass index was 27.7 kg/m (range 18.3-42.9 kg/m ). A significant decrease in mean depression t-scores occurred after implantation of a sacral neuromodulation device, -4.5 (95% confidence interval [CI]: -8.7, -0.2, p = 0.04). Self-reported pain interference (p = 0.37) and physical function (p = 0.47) scores were similar following implantation. Individuals with comorbid anxiety reported the greatest improvement in depression (-6.5, 95% CI: -11.8, -1.1, p = 0.02).
Treatment of FI with sacral neuromodulation was associated with improvement in self-reported depression with the greatest improvement in those with anxiety. Further prospective research is needed to corroborate these findings.
评估骶神经调节治疗粪便失禁(FI)后患者抑郁自评的变化。
这是一项从 2016 年 3 月至 2017 年 10 月收集的数据的回顾性队列研究的亚分析。从电子病历中提取人口统计学信息、病史、精神共病和患者报告的结局测量信息系统(PROMIS)项目库 t 评分。使用双侧配对 t 检验比较 t 评分的差异,p 值<0.05 被认为具有统计学意义。
在队列中(n=24),大多数为白人(88%)、女性(92%)、不吸烟者(92%)。中位年龄为 63.5 岁(四分位间距 57.5-71.0 岁),中位体质指数为 27.7kg/m(范围 18.3-42.9kg/m)。植入骶神经调节装置后,抑郁 t 评分的均值显著下降,为-4.5(95%置信区间[CI]:-8.7,-0.2,p=0.04)。植入后,自我报告的疼痛干扰(p=0.37)和身体功能(p=0.47)评分相似。伴有焦虑共病的个体报告抑郁改善最大(-6.5,95%CI:-11.8,-1.1,p=0.02)。
骶神经调节治疗 FI 与抑郁自评的改善相关,伴有焦虑的患者改善最大。需要进一步的前瞻性研究来证实这些发现。