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Supplementary Material for: Using Electronic Medical Records of Nursing Care to Characterize Constipation in Patients with Intracerebral Hemorrhage

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posted on 18.06.2021, 08:10 by Chen W., Zhao J., Li X., Wang X., Chen J., Zhang T., Ma L., Li D.
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.