Ali Hassam, Pamarthy Rahul, Manickam Swethaa, Sarfraz Shiza, Sahebazamani Mitra, Movahed Hossein
Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, North Carolina.
Department of Internal Medicine, University of Health Sciences, Lahore, Punjab, Pakistan.
Proc (Bayl Univ Med Cent). 2022 Feb 10;35(3):284-290. doi: 10.1080/08998280.2022.2035153. eCollection 2022.
Constipation can be a significant clinical challenge that can compromise management plans and prolong hospital stays. Our goal was to examine the effects of constipation on mechanically ventilated patients, with outcomes related to inpatient stays. We retrospectively analyzed critically ill patients hospitalized with constipation in the 2016 to 2019 National Inpatient Sample (NIS) database. Constipation was defined using Rome IV criteria. Critically ill patients were defined as mechanically ventilated from admission day 1. Our primary outcome was length of stay (LOS) and total hospital charge. Secondary outcomes included predictors of mortality in critically ill patients with constipation. The study included 2,351,119 weighted discharges of mechanically ventilated patients in the NIS database. Of these, 3.7% had constipation. The adjusted LOS was 3.4 days longer in patients with constipation vs those without it ( < 0.001). The adjusted inpatient hospital cost was $31,762 higher in patients with constipation ( < 0.001). Men had higher LOS and inpatient costs. Constipation was not associated with increased inpatient mortality ( < 0.001). Several conditions increased mortality in critically ill patients with constipation, including peritonitis, fecal impaction, and bowel obstruction.
便秘可能是一个重大的临床挑战，会影响治疗计划并延长住院时间。我们的目标是研究便秘对机械通气患者的影响，以及与住院时间相关的结果。我们回顾性分析了2016年至2019年全国住院患者样本（NIS）数据库中因便秘住院的重症患者。便秘采用罗马IV标准进行定义。重症患者定义为从入院第1天开始接受机械通气。我们的主要结局是住院时间（LOS）和总住院费用。次要结局包括便秘重症患者的死亡预测因素。该研究纳入了NIS数据库中2351119例加权出院的机械通气患者。其中，3.7%患有便秘。便秘患者的调整后住院时间比无便秘患者长3.4天（<0.001）。便秘患者的调整后住院费用比无便秘患者高31762美元（<0.001）。男性的住院时间和住院费用更高。便秘与住院死亡率增加无关（<0.001）。几种情况会增加便秘重症患者的死亡率，包括腹膜炎、粪便嵌塞和肠梗阻。
