Neurogenic bowel dysfunction score.
METHODS
Cross-sectional questionnaire study.


OBJECTIVE
To develop and validate a symptom-based score for neurogenic bowel dysfunction (NBD): NBD score.


METHODS
University Hospital of Aarhus, Denmark.


METHODS
A questionnaire including questions about background parameters (n=8), faecal incontinence (n=10), constipation (n=10), obstructed defecation (n=8), and impact on quality of life (QOL) (n=3) was sent to 589 Danish spinal cord injured (SCI) patients. The reproducibility and validity of each item was tested in 20 and 18 patients, respectively. Associations between items and impact on QOL were determined by logistic regression analysis. The NBD score was constructed from items with acceptable reproducibility and validity that were significantly associated with impact on QOL. Based on odds ratios for associations between items and impact on QOL, each item was given a corresponding number of points in the NBD score.


RESULTS
A total of 424 SCI patients responded. The following 10 items met the criteria above: frequency of bowel movements (0-6 points), headache, perspiration or discomfort before or during defecation (0-2 points), tablets and drops against constipation (0-2 points each), time used for each defecation (0-7 points), frequency of digital stimulation or evacuation (0-6 points), frequency of faecal incontinence (0-13 points), medication against faecal incontinence (0-4 points), flatus incontinence (0-2 points) and perianal skin problems (0-3 points). Differences in NBD score among patients reporting no, little, some or major impact on QOL were statistically significant (all P<0.001).


CONCLUSIONS
Based on valid and reproducible questions, we have constructed a score for NBD that is correlated to impact on QOL.
Krogh
K
K
Surgical Research Unit, Department of Surgery L, Section THG, University Hospital of Aarhus, Aarhus, Denmark.
Christensen
P
P
Sabroe
S
S
Laurberg
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003248:Constipation / Q000209:etiology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology*