Does the St. Mark's incontinence score reflect patients' perceptions? A review of 390 patients.

Abstract

The St. Mark's incontinence score is widely used to evaluate the severity of fecal incontinence. It is unknown to what extent such scores relate to patients' perceptions about their condition. The primary goal of this study was to assess this correlation. Secondary goals were to evaluate the relationship between different types of incontinence, age, gender, and the continence score and to assess the sensitivity of St. Mark's incontinence score to a change in patients' perception and outcome evaluation after treatment. Patients' subjective perception of bowel control (using a 0-10 scale) and St. Mark's incontinence score for 390 patients were reviewed. Change in the score was documented for 131 patients who underwent biofeedback treatment and compared with patients' outcome evaluation. There was a moderate correlation between patients' perception of bowel control and the St. Mark's incontinence score (r = -0.55; P < 0.001). The correlation was maintained, regardless of type of incontinence (r = -0.48 to -0.55), age (</=60 years: r = -0.54; >60 years: r = -0.58; P < 0.001) or gender (male: r = -0.48; female: r = -0.53; P < 0.001) of patients. St. Mark's incontinence score was sensitive to a change in patients' subjective evaluation after the treatment. The St. Mark's incontinence score correlates moderately well with patients' subjective perception and is reliable regardless of the type of incontinence, patients' age, or gender. It is suitable for the severity assessment of fecal incontinence and the evaluation of a treatment outcome.