Epidemiology of constipation in critically ill patients and its impact on in-hospital mortality: a retrospective observational study.

Abstract

There are several causes for delayed constipation in critically ill patients. Constipation in critically ill patients is reportedly associated with poor outcomes. However, a consistent definition for constipation and reports on the prognosis of critically ill patients with constipation are lacking. Therefore, we aimed to determine the epidemiology of constipation during critical illness, and assess the association between constipation and in-hospital mortality based on the two definitions of constipation used in previous studies. This retrospective cohort study comprised adult patients in a general intensive care unit (ICU) during 2011-2018. We retrieved the information regarding their bowel movements and assessed the impact of constipation on the in-hospital mortality based on the previous definitions (absence of defecation for 72 and 144h). Among the 1933 adult ICU patients included, the proportion of patients with constipation decreased with a longer duration of constipation (72h: 67%, 144h: 36%). In-hospital mortality in the constipation group was much lower than that in the non-constipation group in the univariable analysis (72h, 27% vs. 13%; 144h, 31% vs. 21%). However, constipation was not associated with in-hospital mortality in the multivariable analysis (adjusted odds ratio: 0.91, 95% confidence interval: 0.64-1.30 and adjusted odds ratio: 1.14, 95% confidence interval: 0.70-1.85 at 72 and 144h, respectively). Constipation in critically ill patients was not associated with in-hospital mortality based on any definition of constipation used in previous studies. Further prospective studies are necessary to validate our findings.