Neurogenic bowel treatments and continence outcomes in children and adults with myelomeningocele
| Autor: | Gordon Worley, Brad E. Dicianno, Jonathan C. Routh, Priya Patel, Heidi Castillo, Eileen Sherburne, Jonathan Castillo, Asma A. Taha, Paula Peterson, Tiebin Liu, John S. Wiener, Kathleen J. Sawin, Kathryn E. Smith, Joan Jasien, Maryellen S. Kelly |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Meningomyelocele Adolescent 030232 urology & nephrology Physical Therapy Sports Therapy and Rehabilitation Enema Logistic regression Article Odds 03 medical and health sciences Young Adult 0302 clinical medicine Neurogenic Bowel 030225 pediatrics Internal medicine Physical Stimulation medicine Fecal continence Fecal incontinence Humans Child Patient registry business.industry Spina bifida Suppositories Rehabilitation medicine.disease Comorbidity Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Female medicine.symptom business Fecal Incontinence |
| Zdroj: | J Pediatr Rehabil Med |
| ISSN: | 1875-8894 |
| Popis: | PURPOSE: Neurogenic bowel dysfunction (NBD) is a common comorbidity of myelomeningocele (MMC), the most common and severe form of spina bifida. The National Spina Bifida Patient Registry (NSBPR) is a research collaboration between the CDC and Spina Bifida Clinics. Fecal continence (continence) outcomes for common treatment modalities for NBD have not been described in a large sample of individuals with MMC. NSBPR patients with MMC and NBD were studied to determine variation in continence status and their ability to perform their treatment independently according to treatment modality and individual characteristics. METHODS: Continence was defined as < 1 episode of incontinence per month. Eleven common treatments were evaluated. Inclusion criteria were established diagnoses of both MMC and NBD, as well as age ≥ 5 years (n = 3670). Chi-square or exact statistical tests were used for bivariate analyses. Logistic regression models were used to estimate the odds of continence outcomes by age, sex, race/ethnicity, level of motor function, and insurance status. RESULTS: At total of 3670 members of the NSBPR met inclusion criteria between November 2013 and December 2017. Overall prevalence of continence was 45%. Prevalence ranged from 40–69% across different treatments. Among continent individuals, 60% achieved continence without surgery. Antegrade enemas were the most commonly used treatment and had the highest associated continence rate. Ability to carry out a treatment independently increased with age. Multivariable logistic regression showed significantly higher odds of continence among individuals aged ≥ 12 years, female, non-Hispanic white, and with private insurance. CONCLUSIONS: The prevalence of continence was generally low and varied between treatment modalities. Better treatment algorithms considering patient factors may result in improved outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|