干旱区生态环境知识资源中心(Arid): The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: a network meta-analysis

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DOI	10.1016/j.ajog.2022.11.1279
	The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: a network meta-analysis
	Okeahialam, Nicola Adanna; Taithongchai, Annika; Thakar, Ranee; Sultan, Abdul H.
通讯作者	Sultan, AH
来源期刊	AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN	0002-9378
EISSN	1097-6868
出版年	2023
卷号	228 期号:6 页码:675-+
英文摘要	OBJECTIVE: This study aimed to systematically determine and compare the incidence of anal incontinence between those with different grades of obstetric anal sphincter injury.DATA SOURCES: Ovid MEDLINE, Embase, and the Cochrane Library were searched from January 2000 to April 2021.STUDY ELIGIBILITY CRITERIA: Observational studies investigating the incidence of anal incontinence following an obstetric anal sphincter injury that was graded using the Sultan classification were eligible for inclusion. To allow comparison between individual tear grades (3a, 3b, 3c, fourth), a network meta-analysis was performed using Stata (version 15.1).METHODS: For binary outcomes, odds ratios with corresponding 95% confidence in-tervals were reported. Obstetric anal sphincter injury grades were ranked from the best clinical outcome to the worst clinical outcome. The percentage chance of each grade taking each rank with regards to outcome was calculated. Study quality and risk of bias was assessed using the relevant tool from the Joanna Briggs Institute.RESULTS: Of the 696 studies identified, 10 were eligible for inclusion and were included in the network meta-analysis (n1/42467 women). The mean incidence of anal inconti-nence among those with 3a tears was 22.4% (range, 6.1%-51.2%), 24.9% (range, 6.9%-46.7%) among those with 3b tears, 26.8% (range, 0%-55.6%) among those with 3c tears, and 28.6% (0%-71.4%) among those with fourth-degree tears. Anal incontinence incidence was found to be significantly higher among those with 3c (odds ratio, 1.79; 95% confidence interval, 1.09-2.94) and fourth-degree tears (odds ratio, 2.37; 95% confidence interval, 1.40-4.02) than among those with 3a tears. In addition, anal incontinence incidence was significantly higher among those with fourth-degree tears (odds ratio, 1.89; 95% confidence interval, 1.10-3.22) than among those with 3b tears. Those with 3a tears had the highest probability of having the best clinical outcome; those with 3b; second-, 3c; third-and fourth-degree tears had the highest probability of having the worst clinical outcome. Overall, all studies had a high or unclear risk of bias across 1 or more assessed element. CONCLUSION: This was a network meta-analysis comparing the incidence of anal in-continence among those with different grades of obstetric anal sphincter injury. Increasing tear-grade severity is associated with worse clinical outcomes. This study provides useful, clinically applicable information that can assist clinicians in the coun-seling of women following an obstetric anal sphincter injury. In addition, it highlights the importance of accurately diagnosing the obstetric anal sphincter injury grade and subsequently performing the appropriate repair.
英文关键词	anal incontinence fecal incontinence fecal urgency flatal incontinence meta-analysis obstetric anal sphincter injuries systematic review
类型	Review
语种	英语
开放获取类型	hybrid, Green Accepted
收录类别	SCI-E
WOS记录号	WOS:001011598000001
WOS关键词	FECAL INCONTINENCE ; CONTINENCE ; PERINEAL ; OUTCOMES ; REPAIR ; OASIS
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/395278
推荐引用方式 GB/T 7714	Okeahialam, Nicola Adanna,Taithongchai, Annika,Thakar, Ranee,et al. The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: a network meta-analysis[J],2023,228(6):675-+.
APA	Okeahialam, Nicola Adanna,Taithongchai, Annika,Thakar, Ranee,&Sultan, Abdul H..(2023).The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: a network meta-analysis.AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY,228(6),675-+.
MLA	Okeahialam, Nicola Adanna,et al."The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: a network meta-analysis".AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 228.6(2023):675-+.