Lim S-F, Ong S Y, Tan Y L, Ng Y S, Chan Y H, Childs C
Specialist Nursing Services, Department of Rehabilitation Medicine, Singapore General Hospital, Singapore; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Int J Clin Pract. 2015 Apr;69(4):422-8. doi: 10.1111/ijcp.12528. Epub 2015 Feb 6.
We investigated new-onset constipation in patients with stroke compared with orthopaedic conditions and explored the predictors associated with constipation during acute hospitalisation.
This was a prospective matched cohort study of 110 patients comparing stroke patients (n = 55) with orthopaedic patients (n = 55) admitted to a large tertiary acute hospital. Both cohorts were matched by age and sex. The incidence of new-onset constipation which occurred during a patient's acute hospitalisation was determined. Demographics, comorbidity, clinical factors, laboratory parameters and medications were evaluated as possible predictors of constipation.
The incidence of new-onset constipation was high for both stroke (33%) and orthopaedic patients (27%; p = 0.66). Seven stroke patients (39%) and four orthopaedic patients (27%) developed their first onset of constipation on day 2 of admission. Mobility gains (RR 0.741, p < 0.001) and the use of prophylactic laxatives (RR 0.331, p < 0.01) had a protective effect against constipation. Bedpan use (RR 2.058, p < 0.05) and longer length of stay (RR 1.032, p < 0.05) increased the risk of developing new-onset constipation.
New-onset constipation is common among patients admitted for stroke and orthopaedic conditions during acute hospitalisation. The early occurrence, on day 2 of admission, calls for prompt preventive intervention for constipation.
我们将中风患者与骨科疾病患者的新发便秘情况进行了调查，并探讨了急性住院期间与便秘相关的预测因素。
这是一项前瞻性匹配队列研究，对110名患者进行了比较，其中包括入住一家大型三级急性医院的中风患者（n = 55）和骨科患者（n = 55）。两个队列均按年龄和性别进行匹配。确定了患者急性住院期间发生的新发便秘发生率。对人口统计学、合并症、临床因素、实验室参数和药物进行评估，作为便秘的可能预测因素。
中风患者（33%）和骨科患者（27%）的新发便秘发生率均较高（p = 0.66）。7名中风患者（39%）和4名骨科患者（27%）在入院第2天首次出现便秘。活动能力增强（相对风险0.741，p < 0.001）和使用预防性泻药（相对风险0.331，p < 0.01）对便秘有保护作用。使用便盆（相对风险2.058，p < 0.05）和住院时间延长（相对风险1.032，p < 0.05）会增加新发便秘的风险。
新发便秘在中风和骨科疾病急性住院患者中很常见。入院第2天就出现便秘，这就需要对便秘进行及时的预防性干预。
