Pelton Matt, Bussetty Arvind, Abdel-Meguid Sarah, Clement Harrison, Mazzaferro Natale, Park Tae Yang, Jagpal Sugeet, Vélez Christopher, Kesavarapu Keerthana
Internal Medicine, Rutgers Robert Wood Johnson, New Brunswick, New Jersey.
School of Public Health Biostatistics and Epidemiology Services, Rutgers, New Brunswick, New Jersey.
Gastro Hep Adv. 2025 Feb 8;4(6):100640. doi: 10.1016/j.gastha.2025.100640. eCollection 2025.
Constipation in patients with cystic fibrosis (PwCF) is a debilitating symptom and, in its most severe forms, is associated with distal intestinal obstruction syndrome. This study aims to characterize the relationship between constipation during hospitalization and the symptoms, complications, and associated health-care costs of constipation in the National Inpatient Sample database.
National Inpatient Sample was queried for discharges in the general population and PwCF from the years 2015-2019. Using International Classification of Diseases, Tenth Revision codes, hospitalized PwCF were matched with the general population on the Charlson comorbidity index, markers of hospitalization severity, and demographics. Subsequently, both were split into 2 cohorts: one with comorbid constipation and one without. Study outcomes were adjusted for gastrointestinal comorbidities, age, sex, and indication for admission.
Of 135,860 discharges, constipation was present in 14.0% in PwCF and 5.6% in the general population with average total charges of $104,270 and length of stay (LOS) of 8.8 days. Constipation was independently associated with increased LOS (1.22 days, standard error [SE] 0.21) and total charges ($14,280, SE $12,308) among PwCF, despite undergoing a similar number of endoscopic procedures (-0.02 SE 0.06). These findings were unchanged on subgroup analysis for sex and indication for hospitalization. Subgroup analysis showed a persistent association of higher costs with constipation in those with pancreatic insufficiency but not those with pancreatic sufficiency ($22,053 vs $493) despite a similar LOS.
Comorbid constipation in hospitalized PwCF was independently associated with increased LOS and costs. The association worsened in those with pancreatic insufficiency.
囊性纤维化患者（PwCF）的便秘是一种使人虚弱的症状，最严重时与远端肠梗阻综合征相关。本研究旨在在国家住院患者样本数据库中，描述住院期间便秘与便秘的症状、并发症及相关医疗费用之间的关系。
查询国家住院患者样本中2015 - 2019年普通人群和PwCF的出院情况。使用国际疾病分类第十版编码，将住院的PwCF与普通人群在查尔森合并症指数、住院严重程度指标和人口统计学特征上进行匹配。随后，两者都被分为两个队列：一个有合并便秘，一个没有。研究结果针对胃肠道合并症、年龄、性别和入院指征进行了调整。
在135,860例出院病例中，PwCF中有14.0%存在便秘，普通人群中为5.6%，平均总费用为104,270美元，住院时间（LOS）为8.8天。尽管接受的内镜检查数量相似（-0.02，标准误[SE] 0.06），但便秘与PwCF中住院时间延长（1.22天，标准误0.21）和总费用增加（14,280美元，标准误12,308美元）独立相关。这些发现在按性别和住院指征进行的亚组分析中没有变化。亚组分析显示，尽管住院时间相似，但胰腺功能不全患者中便秘与较高费用之间存在持续关联，而胰腺功能正常患者则没有（22,053美元对493美元）。
住院的PwCF合并便秘与住院时间延长和费用增加独立相关。在胰腺功能不全的患者中，这种关联更为严重。
