Sano Yuka, Sugama Junko, Koyanagi Hiroe, Murayama Ryoko, Ishihara Takuma, Kohta Masushi, Mano Keiko
Graduate School of Health Sciences, Division of Medical Sciences, Fujita Health University, Toyoake, Aichi, Japan.
Division of Nursing, Fujita Health University Hospital, Toyoake, Aichi, Japan.
Fujita Med J. 2024 Nov;10(4):98-105. doi: 10.20407/fmj.2024-006. Epub 2024 Aug 28.
We aimed to determine (1) the prevalence of constipation among inpatients, (2) the prevalence and symptoms of difficult defecation among constipated inpatients, and (3) the factors associated with constipation.
We performed a retrospective cohort study over a single day at one university hospital. We analyzed the nursing records for inpatients who had been hospitalized for at least 3 days. The survey items included the symptoms associated with defecation difficulty and nutritional intake. The symptoms of difficult defecation were defined as (1) fewer than three spontaneous bowel movements per week; (2) lumpy or hard stools (Bristol stool form scale types 1-2); (3) straining during defecation; and (4) the sensation of incomplete evacuation during defecation, based on the Roma-IV diagnostic criteria. Constipation was defined as the presence of two or more symptoms of defecation difficulty. Univariate and multivariate analyses were performed to determine the constipation status of the patients.
The prevalence of constipation in the university hospital was 12.2%, and the department with the highest prevalence of difficulty with defecation was the Psychiatry Department (64.1%). Of the patients with constipation, 36.8% exhibited symptoms of defecation difficulty other than low frequency of defecation. The factor that was significantly associated with constipation after admission was pre-admission constipation (odds ratio=8.92, <0.01).
Subjective assessment has limitations for the accurate determination of constipation status. In addition, patients with a history of constipation before admission require early interventions to aid defecation following their admission.
我们旨在确定（1）住院患者中便秘的患病率，（2）便秘住院患者中排便困难的患病率及症状，以及（3）与便秘相关的因素。
我们在一家大学医院进行了为期一天的回顾性队列研究。我们分析了住院至少3天的患者的护理记录。调查项目包括与排便困难和营养摄入相关的症状。根据罗马IV诊断标准，排便困难的症状定义为：（1）每周自发排便少于3次；（2）粪便呈块状或坚硬（布里斯托大便分类法1 - 2型）；（3）排便时用力；（4）排便时有未排净的感觉。便秘定义为存在两种或更多排便困难症状。进行单因素和多因素分析以确定患者的便秘状况。
该大学医院便秘的患病率为12.2%，排便困难患病率最高的科室是精神科（64.1%）。在便秘患者中，36.8%除排便频率低外还表现出排便困难的症状。入院后与便秘显著相关的因素是入院前便秘（比值比 = 8.92，<0.01）。
主观评估在准确确定便秘状况方面存在局限性。此外，入院前有便秘病史的患者入院后需要早期干预以帮助排便。
