Using Electronic Medical Records of Nursing Care to Characterize Constipation in Patients with Intracerebral Hemorrhage

Cerebrovasc Dis. 2021;50(5):535-542. doi: 10.1159/000515706. Epub 2021 Jun 18.

Abstract

Introduction: Constipation is one of the common poststroke complications that directly affect the patients' quality of life in patients with intracerebral hemorrhage (ICH), which has not been paid enough attention.

Objective: This study investigates constipation's clinical characteristics and its risk factors in ICH patients driven by the electronic medical records of nursing care.

Methods: This retrospective chart review investigated patients with acute spontaneous ICH admitted at a tertiary care center from October 2010 to December 2018. Poststroke constipation was defined as a first stool passage occurring after 3 days postadmission and the use of enemas or laxatives after ICH. The associations between constipation present and potential factors were evaluated.

Results: Of 1,748 patients, 408 (70.3% men, mean age 58 ± 14 years) patients with poststroke constipation were identified. After adjusting for potential confounding variables, the risk factors independently associated with poststroke constipation are admission Glasgow Coma Scale score (odds ratio [OR] 0.62, 95% confidence interval [CI] 0.44-0.88; p = 0.007), use of mechanical ventilation (OR 3.74, 95% CI 2.37-5.89, p < 0.001), enteral nutrition (OR 2.82, 95% CI 1.85-4.30, p < 0.001), hematoma evacuation (OR 2.10, 95% CI 1.40-3.16; p < 0.001), opioid analgesics (OR 1.86, 95% CI 1.32-2.62; p < 0.001), sedation (OR 1.83, 95% CI 1.20-2.77; p = 0.005), and vasopressors (OR 1.81, 95% CI 1.26-2.61; p = 0.001) in order. Similar associations were observed in the prespecified length of the stay subgroup. Patients with constipation were associated with a longer hospital stay length (2.24 days, 95% CI 1.43-3.05, p < 0.001) but not with in-hospital mortality (OR 1.05, 95% CI 0.58-1.90, p = 0.871).

Conclusions: Our findings suggested that risk factors influence the absence of constipation after ICH with the synergy of different weights. The occurrence of constipation likely affects a longer length of stay, but not in-hospital mortality. Future prospective investigations are warranted to validate our findings and identify the optimal management of constipation that may improve the quality of life in patients with ICH.

Keywords: Characteristics; Constipation; Electronic medical records; Intracerebral hemorrhage.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cerebral Hemorrhage / complications*
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / nursing
  • Cerebral Hemorrhage / physiopathology
  • Constipation / diagnosis
  • Constipation / etiology*
  • Constipation / nursing
  • Constipation / physiopathology
  • Defecation* / drug effects
  • Electronic Health Records*
  • Enema
  • Female
  • Gastrointestinal Motility* / drug effects
  • Humans
  • Laxatives / therapeutic use
  • Length of Stay
  • Male
  • Middle Aged
  • Quality of Life
  • Recovery of Function
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Laxatives