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

Abstract

<b><i>Introduction:</i></b> 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. <b><i>Objective:</i></b> This study investigates constipation’s clinical characteristics and its risk factors in ICH patients driven by the electronic medical records of nursing care. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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; <i>p</i> = 0.007), use of mechanical ventilation (OR 3.74, 95% CI 2.37–5.89, <i>p</i> &#x3c; 0.001), enteral nutrition (OR 2.82, 95% CI 1.85–4.30, <i>p</i> &#x3c; 0.001), hematoma evacuation (OR 2.10, 95% CI 1.40–3.16; <i>p</i> &#x3c; 0.001), opioid analgesics (OR 1.86, 95% CI 1.32–2.62; <i>p</i> &#x3c; 0.001), sedation (OR 1.83, 95% CI 1.20–2.77; <i>p</i> = 0.005), and vasopressors (OR 1.81, 95% CI 1.26–2.61; <i>p</i> = 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, <i>p</i> &#x3c; 0.001) but not with in-hospital mortality (OR 1.05, 95% CI 0.58–1.90, <i>p</i> = 0.871). <b><i>Conclusions:</i></b> 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.