Mack Isabelle, Hahn Heiko, Gödel Celina, Enck Paul, Bharucha Adil E
Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Clin Gastroenterol Hepatol. 2024 Apr;22(4):712-731.e8. doi: 10.1016/j.cgh.2023.09.004. Epub 2023 Sep 19.
BACKGROUND & AIMS: Fecal incontinence (FI) can considerably impair quality of life. Through a systematic review and meta-analysis, we sought to determine the global prevalence and geographic distribution of FI and to characterize its relationship with sex and age.
We searched PubMed, Web of Science, and Cochrane Library databases to identify population-based surveys of the prevalence of FI.
Of the 5175 articles identified, the final analysis included 80 studies; the median response rate was 66% (interquartile range [IQR], 54%-74%). Among 548,316 individuals, the pooled global prevalence of FI was 8.0% (95% confidence interval [CI], 6.8%-9.2%); by Rome criteria, it was 5.4% (95% CI, 3.1%-7.7%). FI prevalence was greater for persons aged 60 years and older (9.3%; 95% CI, 6.6%-12.0%) compared with younger persons (4.9%; 95% CI, 2.9%-6.9%) (odds ratio [OR], 1.75; 95% CI, 1.39-2.20), and it was more prevalent among women (9.1%; 95% CI, 7.6%-10.6%) than men (7.4%; 95% CI, 6.0%-8.8%]) (OR, 1.17; 95% CI, 1.06-1.28). The prevalence was highest in Australia and Oceania, followed by North America, Asia, and Europe, but prevalence could not be estimated in Africa and the Middle East. The risk of bias was low, moderate, and high for 19 (24%), 46 (57%), and 15 (19%) studies, respectively. Exclusion of studies with high risk of bias did not affect the prevalence of FI or heterogeneity. In the meta-regression, the high study heterogeneity (I = 99.61%) was partly explained by age.
Approximately 1 in 12 adults worldwide have FI. The prevalence is greater among women and older people.
大便失禁（FI）会严重损害生活质量。通过系统评价和荟萃分析，我们试图确定FI的全球患病率和地理分布，并描述其与性别和年龄的关系。
我们检索了PubMed、科学网和Cochrane图书馆数据库，以确定基于人群的FI患病率调查。
在识别出的5175篇文章中，最终分析纳入了80项研究；中位应答率为66%（四分位间距[IQR]，54%-74%）。在548316名个体中，FI的合并全球患病率为8.0%（95%置信区间[CI]，6.8%-9.2%）；根据罗马标准，患病率为5.4%（95%CI，3.1%-7.7%）。60岁及以上人群的FI患病率（9.3%；95%CI，6.6%-12.0%）高于较年轻人群（4.9%；95%CI，2.9%-6.9%）（优势比[OR]，1.75；95%CI，1.39-2.20），且女性患病率（9.1%；95%CI，7.6%-10.6%）高于男性（7.4%；95%CI，6.0%-8.8%）（OR，1.17；95%CI，1.06-1.28）。患病率在澳大利亚和大洋洲最高，其次是北美、亚洲和欧洲，但非洲和中东地区的患病率无法估计。19项（24%）、46项（57%）和15项（19%）研究的偏倚风险分别为低、中、高。排除偏倚风险高的研究对FI患病率或异质性无影响。在meta回归中，研究的高异质性（I=99.61%）部分可由年龄解释。
全球约每12名成年人中就有1人患有FI。女性和老年人中的患病率更高。
