New objective scoring system to clinically assess fecal incontinence  

作　　者：Pankaj Garg Iwona Sudol-Szopinska Małgorzata Kolodziejczak Kaushik Bhattacharya Gurleen Kaur 

机构地区：[1]Colorectal Surgery,Garg Fistula Research Institute(GFRI),Panchkula 134113,Haryana,India [2]Colorectal Surgery,Indus International Hospital,Mohali 140507,Punjab,India [3]Department ofRadiology,National Institute of Geriatrics,Rheumatology and Rehabilitation,Warsaw 02-637,Poland [4]Department of Proctology,Proctologic Center,St.Elizabeth Hospital,Warsaw 02-616,Poland [5]Department of Surgery,MGM Medical College and LSK Hospital,Kishanganj 855107,Bihar,India [6]Department of Pharmacology,Adesh Medical College and Hospital,Shahbad 136143,Haryana,India

出　　处：《World Journal of Gastroenterology》2023年第29期4593-4603,共11页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Several scoring systems are used to assess fecal incontinence(FI),among which,the most commonly used are Wexner and Vaizey’s scoring systems.However,there are significant lacunae in these scoring systems,due to which they are neither accurate nor comprehensive.AIM To develop a new scoring system for FI that is accurate,comprehensive,and easy to use.METHODS A pro forma was made in which six types of FI were included:solid,liquid,flatus,mucous,stress,and urge.The weight for each FI was determined by asking a group of patients and laypersons to give a disability score to each type of FI from 0 to 100(0-least,100-maximum disability).The disability was assessed on a modified EQ-5D+(EuroQol)description system,4D3L(4 dimensions and 3 levels)for each FI.The average score of each FI was calculated,divided by 10,and rounded off to determine the weight of each FI type.The scores for the three levels of frequency of each FI were assigned as never=0(No episode of FI ever),occasional=1(≤1 episode of FI/wk),and common=2(>1 episode of FI/wk),and was termed as frequency score.The score for each FI would be derived by multiplying the frequency score and the weight for that FI type.In the second phase of the study,a group of colorectal surgeons was asked to rank the six FI types in order of severity,and their ranking was compared with the patient and laypersons’rankings.RESULTS Fifty patients and 50 laypersons participated in the study.The weight was assigned to each FI(solid-8,liquid-8,urge-7,flatus-6,mucus-6,and stress-5),and an new scoring system was formulated.The maximum possible score was 80(total incontinence),and the least 0(no incontinence).The surgeons’ranking of FI severity did not correlate well with patients’and laypersons’rankings of FI,highlighting that surgeons and patients may perceive the severity of FI differently.CONCLUSION A new scoring system for FI was formulated,which was simple,logical,comprehensive,and easy to use,and eliminated previous shortcomings.Patients’and surgeons’percept

关 键 词：Feal incontinence Scoring system URGE STRESS Flatus 

分 类 号：R657.1[医药卫生—外科学]