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Constipation prophylaxis reduces length of stay in elderly hospitalized heart failure patients with home laxative use.
J Gastroenterol Hepatol. 2015 May 13;
Authors: Staller K, Khalili H, Kuo B
Abstract
BACKGROUND AND AIM: Elderly, hospitalized patients suffer disproportionately from constipation, however little data suggests that constipation prophylaxis reduces length of stay (LOS). We performed a retrospective analysis of elderly patients admitted to our hospital with congestive heart failure (CHF) to determine the effects of constipation prophylaxis on LOS.
METHODS: Patients ≥65 years old admitted with the diagnosis of CHF in 2012 were evaluated for home and hospital laxative use on admission. Our primary outcome was LOS. We used linear regression modeling to independently evaluate the impact of constipation prophylaxis on LOS.
RESULTS: Among 618 patients who were eligible for our study, 201 (32.5%) were using laxatives at home whereas 254 (41.1%) were started on a prophylactic laxative on admission. There was no significant difference in LOS between patients receiving prophylaxis vs. those that did not (P=0.32). Patients with home laxative use had a 1 day longer LOS compared to those without laxative use (6 vs. 5, P=0.03). Among patients with home laxative use, there was 2 day longer LOS in those who were not given constipation prophylaxis on admission (8 vs. 6, P=0.002). After multivariate adjustment, failure to use constipation prophylaxis in patients with home laxative use was the only independent predictor of increased LOS (P=0.03).
CONCLUSIONS: Among elderly patients admitted for CHF exacerbations, failure to use constipation prophylaxis in patients with home laxative use is associated with a significantly-longer LOS. Our data suggest that routine use of bowel prophylaxis for elderly CHF patients with preexisting constipation may reduce LOS.
PMID: 25969162 [PubMed - as supplied by publisher]