尿急是评估大便失禁的一个重要因素。

IF 2.4 3区 医学 Q2 SURGERY
Updates in Surgery Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI:10.1007/s13304-024-01975-4
Louise Almkvist, Ulf Gunnarsson, Karin Strigård
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引用次数: 0

摘要

本研究旨在探讨在评估大便失禁(FI)时,低位前切除综合征(LARS)评分是否能为韦克斯纳评分提供补充信息。该研究的假设是,无论病因如何,LARS 评分都有可能在评估 FI 时为 Wexner 评分提供补充信息。LARS 评分已被用作传统评分系统的补充,用于评估排便功能障碍,主要针对根治性膀胱切除术后患者、子宫内膜异位症妇女和结直肠癌患者的大便失禁。韦克斯纳评分作为一种单一的工具,并不能解决 FI 和紧迫感(一种致残症状)的复杂性。一项外科门诊的回顾性队列研究纳入了2015年1月1日至2018年12月31日期间首次就诊时回答LARS和Wexner评分问卷的确诊FI患者。对参与者和特定亚组进行了 Kendall's tau、Spearman 秩相关、Cohen's kappa 和散点图分析,以评估两种评分系统答案之间的相关性和一致性。有 119 名患者符合纳入标准,其中有 18 名女性和 11 名男性。Kendall's tau 介于 0.32 到 0.39 之间,表明缺乏相关性。斯皮尔曼等级相关系数介于 0.36 至 0.55 之间,即仅存在一般至中等程度的相关性。Kappa为0.21-0.28,即只有轻微到一般的一致性。在散点图中,LARS 和韦克斯纳评分的分布显示出很大的差异性,且缺乏一致性。综合使用 Wexner 和 LARS 分数可提供补充信息,从而更全面地绘制 FI 图,并将所有实体考虑在内。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Urgency an important factor when assessing fecal incontinence.

Urgency an important factor when assessing fecal incontinence.

The aim of this study was to investigate if Low Anterior Resection Syndrome (LARS) score contributed with complementary information to Wexner score when assessing fecal incontinence (FI). The hypothesis was that LARS score would be likely to provide complementary information to Wexner score in the assessment of FI regardless of etiology. LARS score has been used as a complement to traditional scoring systems to assess bowel dysfunction, targeting FI among patients after radical cystectomy, in women with endometriosis, and in colorectal cancer patients. Wexner score as a single tool does not address the complexity of FI and urgency, a disabling symptom. A retrospective cohort study at a surgical outpatient clinic included patients diagnosed with FI who answered LARS and Wexner scores questionnaires at their first visit to the clinic between 1st January 2015 and 31st December 2018. Kendall's tau, Spearman rank correlation, Cohen's kappa, and scatterplots were analyzed for participants and specific subgroups to assess any correlation and agreement between answers to the two scoring systems. One hundred nineteen patients met the inclusion criteria, one hundred eight women and eleven men. Kendall's tau ranged from 0.32 to 0.39, indicating lack of correlation. Correlation coefficients using Spearman rank ranged from 0.36 to 0.55, i.e., only fair to moderate correlation. Kappa was 0.21-0.28, i.e., only slight to fair agreement. Distribution of LARS and Wexner scores in the scatterplot showed wide variability and lack of agreement. Combined use of both the Wexner and LARS scores provided complimentary information, and thus a more complete mapping of FI as well as taking all entities in consideration.

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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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