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

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Abstract

Purpose

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.

Methods

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 144 h).

Results

Among the 1933 adult ICU patients included, the proportion of patients with constipation decreased with a longer duration of constipation (72 h: 67%, 144 h: 36%). In-hospital mortality in the constipation group was much lower than that in the non-constipation group in the univariable analysis (72 h, 27% vs. 13%; 144 h, 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 144 h, respectively).

Conclusions

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.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Takuo Yoshida

    Present address: Department of Intensive Care Medicine, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan

  2. Shigehiko Uchino

    Present address: Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Centre, 1-847 Amanuma, Omiya-ku, Saitama, Saitama, Japan

Authors and Affiliations

  1. Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, 3-19-18, Nishi-Shinbashi Minato-ku, Tokyo, Japan

    Takuo Yoshida & Shigehiko Uchino

  2. Data Science Center, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, Japan

    Yusuke Sasabuchi

Authors
  1. Takuo Yoshida
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  3. Yusuke Sasabuchi
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Contributions

TY, SU, and YS (all authors) developed the study concept and design. TY performed data acquisition and drafted the manuscript. All the authors performed data analysis and interpretation and critical revision of the manuscript for important intellectual content. TY has full access to all the study data and takes responsibility for its integrity. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Takuo Yoshida.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The study protocol adheres to the principles of the Declaration of Helsinki and ethical guidelines for epidemiological research by Japan’s Ministry of Education, Culture, Sports, Science and Technology and Ministry of Health, Labour and Welfare. The study protocol was approved by the Jikei University Institutional Review Board with an opt-out policy from the patient or their proxy (31–471[10053]). Written informed consent was waived in view of the observational nature of this study.

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Yoshida, T., Uchino, S. & Sasabuchi, Y. Epidemiology of constipation in critically ill patients and its impact on in-hospital mortality: a retrospective observational study. J Anesth 36, 349–358 (2022). https://doi.org/10.1007/s00540-022-03050-x

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  • DOI: https://doi.org/10.1007/s00540-022-03050-x

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