The Incidence, Risk Factors, and Effects of Constipation in Critical Patients: An Observational Cross-sectional Study

Abstract

Objective: This study aimed to investigate the early, late, and total constipation frequency, related factors, and their effects on the hospitalization day, gastric residual volume, vomiting, distension, and diarrhea, the feeding type, white blood cells, and C-reactive protein levels, and body temperature. Method: Data from this observational cross-sectional study were collected in an anesthesia and reanimation intensive care unit of a public hospital in Bolu, Turkey. The sample included 116 patients who met the criteria of the study. The sample size was determined using power analysis according to the results of a pilot study. The patient information form, daily observation form, and Bristol stool consistency scale were used for collecting the data. Results: The constipation frequency was 63.8% in the unit. The early constipation frequency was 18.9%, and the late constipation frequency was 6.8%. The hospitalization day in these groups was longer than those without constipation. Also, the patients receiving mechanical ventilator support, enteral tube feeding, and diuretic medication had a higher risk for constipation. The enema/laxative was applied to half of the patients who developed constipation in the unit, after which more than half developed diarrhea. Distension and enteral feeding were more frequent in late-type constipation patients. The levels of white blood cells, C-reactive protein levels, and body temperature between all groups were not statistically different (p>0.05). Conclusion: The frequency of constipation was higher in the intensive care unit, even when the defecation period was considered four days. Receiving mechanical ventilator support, enteral tube feeding, and diuretics increased the risk of constipation.

Keywords

• critical care
• constipation
• intensive care
• nursing