Prevalence of constipation and use of laxatives, and association with risk factors among older patients during hospitalization: a cross sectional study

Abstract

Background Many older patients experience constipation as a bothersome symptom with a negative impact on quality of life. During hospitalization, the focus is often on the reason for admission with the risk that other health problems are not prioritized. The aim of the study was to describe the prevalence of constipation and use of laxatives among older hospitalized patients and to investigate the associations with demographic factors, risk assessments and prescribed medications. Methods A descriptive retrospective cross-sectional study design was used. This study enrolled patients aged 65 years or older admitted to a geriatric department. Data from electronic health records regarding constipation, demographics, risk assessments, medical diagnoses, prescribed medications and length of stay were extracted. Constipation was assessed using ICD- 10 diagnosis, documented signs and symptoms of constipation, and prescribed laxatives. Data was analyzed using descriptive and comparative analyses, including logistic regression. Results In total, 6% of the patients had an ICD-10 diagnosis of constipation, 65% had signs and symptoms of constipation, and 60% had been prescribed laxatives. Only 5% of the patients had constipation documented according to ICD-10, signs and symptoms, and prescribed laxatives. Signs and symptoms of constipation were associated with prescribed opioids (OR = 2.254) and longer length of stay (OR = 1.063). Being prescribed laxatives was associated with longer length of stay (OR = 1.109), prescribed opioids (OR = 2.154), and older age (OR = 1.030). Conclusions The prevalence of constipation varies depending on the methods used to identify the condition. There was a discrepancy between the documentation of constipation in relation to sign and symptoms, ICD-10 diagnosis and prescribed laxatives. The documentation of constipation was not consistent for the three methods of assessment.

Prevalence, Recognition, and Risk Factors of Constipation among Medically Hospitalized Patients: A Cohort Prospective Study

“…In a recent retrospective cross-sectional study involving elderly hospitalized patients (n = 321), only 6% were diagnosed with constipation based on ICD-10 codes. However, clinical documentation indicated that 65% of these patients exhibited signs and symptoms of constipation [ 14 ]. Overall, the reported prevalence of constipation in acutely hospitalized patients varies widely, ranging from 14.8% to 65% [ 13 , 14 , 15 , 16 ].…”

“…Based on previous studies, the reported prevalence of constipation in acutely hospitalized patients varied from 14.8% to 65% [ 13 , 14 , 15 , 16 ]. To determine the prevalence of constipation in our specific hospital setting, we estimated that a minimum of 391 patients would be required, considering a 95% confidence interval and a 5% margin of error.…”

“…In contrast to community and outpatient settings, there has been limited research on the prevalence of constipation specifically among hospitalized patients. Previous studies have reported varying prevalence rates of constipation in acutely hospitalized patients, ranging from 14.8% to 65% [ 13 , 14 , 15 , 16 ]. The reported variation in prevalence rates can be attributed to the utilization of different definitions for constipation and the reliance on retrospective reviews of patients’ records [ 14 ].…”

“…Previous studies have reported varying prevalence rates of constipation in acutely hospitalized patients, ranging from 14.8% to 65% [ 13 , 14 , 15 , 16 ]. The reported variation in prevalence rates can be attributed to the utilization of different definitions for constipation and the reliance on retrospective reviews of patients’ records [ 14 ]. Old age, use of certain medications such as opioids, and increased length of hospital stay were associated with increased prevalence of constipation in hospitalized patients [ 13 , 14 , 15 , 16 ].…”

The Burden and Treatment of Chronic Constipation Among US Nursing Home Residents

“… 17 Identifying CC in secondary data is challenging; although laxatives and treatments are often prescribed, a diagnosis of constipation or CC is often undocumented. 18 Furthermore, there are no validated algorithms for identifying constipation in Medicare claims or EHR data. For this study, we used a composite definition, in which CC was coded if one or both criteria were met: (1) the MDS indicator for constipation was checked (item H0600) and/or (2) chronic DTC use.…”