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Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity

AIM: To explore the relationship between such a construct and an existing continence score. METHODS: A retrospective study of incontinent patients who underwent anal physiology (AP) was performed. AP results and Cleveland Clinic Continence Scores (CCCS) were extracted. An anal physiology score (APS)...

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Autores principales: Young, Christopher J, Zahid, Assad, Koh, Cherry E, Young, Jane M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569287/
https://www.ncbi.nlm.nih.gov/pubmed/28883698
http://dx.doi.org/10.3748/wjg.v23.i31.5732
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author Young, Christopher J
Zahid, Assad
Koh, Cherry E
Young, Jane M
author_facet Young, Christopher J
Zahid, Assad
Koh, Cherry E
Young, Jane M
author_sort Young, Christopher J
collection PubMed
description AIM: To explore the relationship between such a construct and an existing continence score. METHODS: A retrospective study of incontinent patients who underwent anal physiology (AP) was performed. AP results and Cleveland Clinic Continence Scores (CCCS) were extracted. An anal physiology score (APS) was developed using maximum resting pressures (MRP), anal canal length (ACL), internal and external sphincter defects and pudendal terminal motor latency. Univariate associations between each variable, APS and CCCS were assessed. Multiple regression analyses were performed. RESULTS: Of 508 (419 women) patients, 311 had both APS and CCCS measured. Average MRP was 51 mmHg (SD 23.2 mmHg) for men and 39 mmHg (19.2 mmHg) for women. Functional ACL was 1.7 cm for men and 0.7 cm for women. Univariate analyses demonstrated significant associations between CCCS and MRP (P = 0.0002), ACL (P = 0.0006) and pudendal neuropathy (P < 0.0001). The association between APS and CCCS was significant (P < 0.0001) but accounted for only 9.2% of the variability in CCCS. Multiple regression showed that the variables most useful in predicting CCCS were external sphincter defect, pudendal neuropathy and previous pelvic surgery, but only improving the scores predictive ability to 12.5%. CONCLUSION: This study shows that the ability of AP tests to predict continence scores improves when considered collectively, but that a constructed summation model before and after multiple regression is poor at predicting the variability in continence scores.
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spelling pubmed-55692872017-09-07 Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity Young, Christopher J Zahid, Assad Koh, Cherry E Young, Jane M World J Gastroenterol Retrospective Cohort Study AIM: To explore the relationship between such a construct and an existing continence score. METHODS: A retrospective study of incontinent patients who underwent anal physiology (AP) was performed. AP results and Cleveland Clinic Continence Scores (CCCS) were extracted. An anal physiology score (APS) was developed using maximum resting pressures (MRP), anal canal length (ACL), internal and external sphincter defects and pudendal terminal motor latency. Univariate associations between each variable, APS and CCCS were assessed. Multiple regression analyses were performed. RESULTS: Of 508 (419 women) patients, 311 had both APS and CCCS measured. Average MRP was 51 mmHg (SD 23.2 mmHg) for men and 39 mmHg (19.2 mmHg) for women. Functional ACL was 1.7 cm for men and 0.7 cm for women. Univariate analyses demonstrated significant associations between CCCS and MRP (P = 0.0002), ACL (P = 0.0006) and pudendal neuropathy (P < 0.0001). The association between APS and CCCS was significant (P < 0.0001) but accounted for only 9.2% of the variability in CCCS. Multiple regression showed that the variables most useful in predicting CCCS were external sphincter defect, pudendal neuropathy and previous pelvic surgery, but only improving the scores predictive ability to 12.5%. CONCLUSION: This study shows that the ability of AP tests to predict continence scores improves when considered collectively, but that a constructed summation model before and after multiple regression is poor at predicting the variability in continence scores. Baishideng Publishing Group Inc 2017-08-21 2017-08-21 /pmc/articles/PMC5569287/ /pubmed/28883698 http://dx.doi.org/10.3748/wjg.v23.i31.5732 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Young, Christopher J
Zahid, Assad
Koh, Cherry E
Young, Jane M
Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity
title Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity
title_full Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity
title_fullStr Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity
title_full_unstemmed Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity
title_short Hypothesized summative anal physiology score correlates but poorly predicts incontinence severity
title_sort hypothesized summative anal physiology score correlates but poorly predicts incontinence severity
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569287/
https://www.ncbi.nlm.nih.gov/pubmed/28883698
http://dx.doi.org/10.3748/wjg.v23.i31.5732
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