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Significant Morbidity and Mortality Associated with Fecal Impaction in Patients Who Present to the Emergency Department

  • Thomas Sommers
  • Travis Petersen
  • Prashant Singh
  • Vikram Rangan
  • William Hirsch
  • Jesse Katon
  • Sarah Ballou
  • Vivian Cheng
  • Daniel Friedlander
  • Judy Nee
  • Anthony Lembo
  • Johanna Iturrino
Original Article
  • 8 Downloads

Abstract

Background

Fecal impaction (FI) is defined as a large mass of stool in the rectum and/or colon that is unable to be evacuated. No study to date details demographics and outcomes in a sizeable sample of FI patients in the USA.

Aims

The present study aims to develop knowledge of FI by reporting descriptive measures and outcomes of patients presenting to a US emergency department (ED) with FI.

Methods

Medical charts coded with FI at Beth Israel Deaconess Medical Center from 2016 or 2017 were identified retrospectively. Patients diagnosed with FI in the ED or subsequent to direct hospital admission from the ED were included. Patient-specific demographics, visit-specific details, medical and medication histories, and hospital treatment and outcome measures were included in a database and analyzed.

Results

Thirty-two patients (mean age of 72.9 years, 62.5% female) had a total of 42 ED visits with FI. Patients had an average of 8.7 diagnoses and 11.2 medications listed in their charts. 54.8% of patients were taking at least one commonly prescribed constipating medication. The median total length of stay for admitted patients was 3 days, with nearly 90% of the ED visits with FI requiring hospital admission. 40.6% of patients experienced serious FI-related morbidities, and 21.9% of patients with FI died in the hospital.

Conclusion

Patients presenting with FI had high risk of morbidity and mortality, complex medical histories, and large numbers of active treatment regimens. Patients with FI should receive immediate treatment and close monitoring for morbidities and complications.

Keywords

Fecal impaction Constipation Morbidity Mortality Opioids Epidemiology 

Notes

Author’s contribution

T.S., A.L., and J.I. conceived the idea of the study. The manuscript was drafted by T.S. Data collection and statistical analyses were performed by T.P. and T.S. The draft manuscript was critically reviewed by T.P., P.S., V.R., W.H., J.K., S.B., V.C., D.F., J.N., A.L., and J.I. All authors reviewed and approved the final version of the manuscript.

Funding

This project was funded in part by RO1 AT008573-03 (AL) and T32DK007760 (SB and PS).

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Thomas Sommers
    • 1
  • Travis Petersen
    • 1
  • Prashant Singh
    • 1
  • Vikram Rangan
    • 1
  • William Hirsch
    • 1
  • Jesse Katon
    • 1
  • Sarah Ballou
    • 1
  • Vivian Cheng
    • 1
  • Daniel Friedlander
    • 1
  • Judy Nee
    • 1
  • Anthony Lembo
    • 1
  • Johanna Iturrino
    • 1
  1. 1.Division of Gastroenterology, Department of MedicineBeth Israel Deaconess Medical Center, Harvard Medical SchoolBostonUSA

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