Literature DB >> 30535766

Significant Morbidity and Mortality Associated with Fecal Impaction in Patients Who Present to the Emergency Department.

Thomas Sommers1, Travis Petersen1, Prashant Singh1, Vikram Rangan1, William Hirsch1, Jesse Katon1, Sarah Ballou1, Vivian Cheng1, Daniel Friedlander1, Judy Nee1, Anthony Lembo2, Johanna Iturrino1.   

Abstract

BACKGROUND: Fecal impaction (FI) is defined as a large mass of stool in the rectum and/or colon that is unable to be evacuated. No study to date details demographics and outcomes in a sizeable sample of FI patients in the USA. AIMS: The present study aims to develop knowledge of FI by reporting descriptive measures and outcomes of patients presenting to a US emergency department (ED) with FI.
METHODS: Medical charts coded with FI at Beth Israel Deaconess Medical Center from 2016 or 2017 were identified retrospectively. Patients diagnosed with FI in the ED or subsequent to direct hospital admission from the ED were included. Patient-specific demographics, visit-specific details, medical and medication histories, and hospital treatment and outcome measures were included in a database and analyzed.
RESULTS: Thirty-two patients (mean age of 72.9 years, 62.5% female) had a total of 42 ED visits with FI. Patients had an average of 8.7 diagnoses and 11.2 medications listed in their charts. 54.8% of patients were taking at least one commonly prescribed constipating medication. The median total length of stay for admitted patients was 3 days, with nearly 90% of the ED visits with FI requiring hospital admission. 40.6% of patients experienced serious FI-related morbidities, and 21.9% of patients with FI died in the hospital.
CONCLUSION: Patients presenting with FI had high risk of morbidity and mortality, complex medical histories, and large numbers of active treatment regimens. Patients with FI should receive immediate treatment and close monitoring for morbidities and complications.

Entities:  

Keywords:  Constipation; Epidemiology; Fecal impaction; Morbidity; Mortality; Opioids

Mesh:

Year:  2018        PMID: 30535766      PMCID: PMC6499648          DOI: 10.1007/s10620-018-5394-8

Source DB:  PubMed          Journal:  Dig Dis Sci        ISSN: 0163-2116            Impact factor:   3.199


  14 in total

Review 1.  Functional bowel disorders in the geriatric patient: constipation, fecal impaction, and fecal incontinence.

Authors:  A R De Lillo; S Rose
Journal:  Am J Gastroenterol       Date:  2000-04       Impact factor: 10.864

2.  Report of an unusual case with severe fecal impaction responding to medication therapy.

Authors:  Wei Zhao; Meiyun Ke
Journal:  J Neurogastroenterol Motil       Date:  2010-04-27       Impact factor: 4.924

3.  Stercoraceous ulcers of the colon: relatively neglected medical and surgical problem.

Authors:  H T GRINVALSKY; C I BOWERMAN
Journal:  J Am Med Assoc       Date:  1959-12-05

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Authors:  Farshid Araghizadeh
Journal:  Clin Colon Rectal Surg       Date:  2005-05

5.  Development of hydronephrosis secondary to poorly managed neurogenic bowel requiring surgical disimpaction in a patient with spinal cord injury: a case report.

Authors:  Jairon Downs; Tracy Wolfe; Heather Walker
Journal:  J Spinal Cord Med       Date:  2014-03-12       Impact factor: 1.985

Review 6.  Fecal impaction.

Authors:  K Wrenn
Journal:  N Engl J Med       Date:  1989-09-07       Impact factor: 91.245

7.  Megacolon and stercoral proctitis after frequent fecal impactions: report of an unusual case and review of the literature.

Authors:  Jen-Tzer Gau; Utkarsh Acharya; Tracy Marx; G Nicholas Verne; Wayne Carlsen
Journal:  J Am Med Dir Assoc       Date:  2007-05-03       Impact factor: 4.669

8.  Fecal impaction: a cause for concern?

Authors:  Izi Obokhare
Journal:  Clin Colon Rectal Surg       Date:  2012-03

9.  A nation-wide study of prevalence and risk factors for fecal impaction in nursing homes.

Authors:  Enrique Rey; Marta Barcelo; Maria Jose Jiménez Cebrián; Angel Alvarez-Sanchez; Manuel Diaz-Rubio; Alberto Lopez Rocha
Journal:  PLoS One       Date:  2014-08-22       Impact factor: 3.240

10.  Validation of a questionnaire for assessing fecal impaction in the elderly: impact of cognitive impairment, and using a proxy.

Authors:  Marta Barcelo; Maria Jose Jimenez-Cebrian; Manuel Diaz-Rubio; Alberto Lopez Rocha; Enrique Rey
Journal:  BMC Geriatr       Date:  2013-03-07       Impact factor: 3.921

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  1 in total

1.  Effect of constipation on outcomes in mechanically ventilated patients.

Authors:  Hassam Ali; Rahul Pamarthy; Swethaa Manickam; Shiza Sarfraz; Mitra Sahebazamani; Hossein Movahed
Journal:  Proc (Bayl Univ Med Cent)       Date:  2022-02-10
  1 in total

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