Fecal incontinence in females older than aged 40 years: Who is at risk?
Fecal incontinence in females older than aged 40 years: Who is at risk?
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DOI：
10.1007/s10350-006-0535-0
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发表时间：
2006-06-01
影响因子：
3.9
通讯作者：
Subak, LL
中科院分区：
文献类型：
--
作者：
Varma, MG;Brown, JS;Subak, LL
目的：这项研究旨在评估40岁以上不同种族女性大便失禁的患病率，并确定与之相关的危险因素。方法：Kaiser的大小便失禁生殖风险研究是一项基于人群的研究，随机选择2109名中老年女性(平均年龄56岁)。通过自我报告确定大便失禁，并根据频率进行分类。女性报告了大便失禁的困扰程度和她们的总体生活质量。潜在危险因素通过自我报告、访谈、体检和病历回顾进行评估。采用多变量Logistic回归分析来确定选定的危险因素与过去一年中报告的任何大便失禁的主要结局之间的独立关联。结果：在过去的一年里，24%的女性报告了大便失禁(每月3.4%，每周1.9%，每天0.2%)。大便失禁频率较高与生活质量下降(医学结果简明36精神成分量表得分，P=0.001)和增加麻烦(P<；0.001)有关，45%的女性在过去一年中大便失禁，100%的女性每天大便失禁报告中度或极大的麻烦。在多因素分析中，过去一年大便失禁的患病率显著增加[每5公斤/米(2)的优势比(95%可信区间)]，肥胖[1.2(1.1-1.3)]、慢性阻塞性肺疾病[1.9(1.3-2.9)]、肠易激综合征[2.4(1.7-3.4)]、尿失禁[2.1(1.7-2.6)]和结肠切除[1.9(1.1-3.1)]。拉丁裔女性报告大便失禁的可能性低于白人女性[0.6(0.4-0.9)]。结论：大便失禁是女性的常见问题，与生活质量的严重不良影响有关。已确定的几个危险因素是可以预防或改变的，可能会指导未来对大便失禁治疗的研究。
PURPOSE: This study was designed to estimate the prevalence of, and identify risk factors associated with, fecal incontinence in racially diverse females older than aged 40 years. METHODS: The Reproductive Risks for Incontinence Study at Kaiser is a population-based study of 2,109 randomly selected middle-aged and older females (average age, 56 years). Fecal incontinence, determined by self-report, was categorized by frequency. Females reported the level of bother of fecal incontinence and their general quality of life. Potential risk factors were assessed by self-report, interview, physical examination, and record review. Multivariate logistic regression analysis was used to determine the independent association between selected risk factors and the primary outcome of any reported fecal incontinence in the past year. RESULTS: Fecal incontinence in the past year was reported by 24 percent of females (3.4 percent monthly, 1.9 percent weekly, and 0.2 percent daily). Greater frequency of fecal incontinence was associated with decreased quality of life (Medical Outcome Short Form-36 Mental Component Scale score, P = 0.01), and increased bother (P < 0.001) with 45 percent of females with fecal incontinence in the past year and 100 percent of females with daily fecal incontinence reporting moderate or great bother. In multivariate analysis, the prevalence of fecal incontinence in the past year increased significantly [odds ratio per 5 kg/m(2) (95 percent confidence interval)] with obesity [1.2 (1.1-1.3)], chronic obstructive pulmonary disease [1.9 (1.3-2.9)], irritable bowel syndrome [2.4 (1.7-3.4)], urinary incontinence [2.1 (1.7-2.6)], and colectomy [1.9 (1.1-3.1)]. Latina females were less likely to report fecal incontinence than white females [0.6 (0.4-0.9)]. CONCLUSIONS: Fecal incontinence, a common problem for females, is associated with substantial adverse affects on quality of life. Several of the identified risk factors are preventable or modifiable, and may direct future research in fecal incontinence therapy.