Estreñimiento en una cohorte prospectiva de adultos críticos: porcentaje y motivo de su incidencia / Constipation in a cohort prospective in adult critically ill patients: How much occurs and why?

Objetivo: Valorar la incidencia y factores de riesgo asociados al estreñimiento en pacientes adultos, en estado crítico. Diseño: Estudio prospectivo de cohortes. Ámbito: Unidad de cuidados intensivos (UCI) de un hospital de alta complejidad de noviembre de 2015 a octubre de 2016. Sujetos: Se realizó un seguimiento a los adultos que fueron hospitalizados durante al menos 72 h en la UCI, desde su ingreso en dicha unidad hasta su salida. Intervenciones: Ninguna. Mediciones y resultados principales: En los 157 pacientes seguidos, la incidencia de estreñimiento fue del 75,8%. El análisis univariado mostró que los pacientes con estreñimiento eran más jóvenes, habían usado más sedación y habían tenido más problemas respiratorios y posoperatorios como causas de hospitalización. Los pacientes sin estreñimiento habían sido hospitalizados más veces debido a motivos gastrointestinales. El uso de fármacos vasoactivos, la ventilación mecánica y la hemodiálisis fue similar entre los pacientes con estreñimiento y aquellos sin estreñimiento. El análisis multivariado, los días de administración de docusato + bisacodilo (HR0,79; IC95%: 0,65-0,96), de omeprazol o ranitidina (HR: 0,80; IC95%: 0,73-0,88) y de lactulosa (HR: 0,87; IC95%: 0,76-0,99) fueron factores independientes de protección para el estreñimiento. Conclusión: El estreñimiento es muy incidente en los adultos críticos. Los días de administración de fármacos que actúan sobre el tracto digestivo (Lactulosa, docusato + bisacodil y omeprazol y/o ranitidina) son capaces de prevenir este desenlace

Objective: To assess the incidence and factors associated with constipation in adult critical care patients. Design: Prospective cohort study. Setting: Intensive care unit (ICU) of a high-complexity hospital from November 2015 to October 2016. Patients: Adults who were hospitalized for at least 72 h in the ICU were followed from their admission to the ICU until their departure. Interventions: None. Measurements and main results: In the 157 patients followed up, the incidence of constipation was 75.8%. The univariate analysis showed that constipated patients were younger, used more sedation and showed more respiratory and postoperative causes for hospitalization, while non-constipated patients were hospitalized more for gastrointestinal reasons. The use of vasoactive substances, mechanical ventilation and haemodialysis was similar between the constipated and non-constipated patients. Multivariate analysis, days of use of docusate + bisacodyl (HR: .79; 95% CI: .65-.96) of omeprazole or ranitidine (HR: .80; 95%CI: .73-.88) and lactulose (HR: .87; 95%CI: .76-.99) were independent protection factors for constipation. Conclusion: Constipation has a high incidence among adult critical care patients. Days of drug use acting on the digestive tract (lactulose, docusate + bisacodyl and omeprazole and/or ranitidine) are able to prevent this outcome

Constipation in a cohort prospective in adult critically ill patients: How much occurs and why? / Estreñimiento en una cohorte prospectiva de adultos críticos: porcentaje y motivo de su incidencia.

OBJECTIVE: To assess the incidence and factors associated with constipation in adult critical care patients. DESIGN: Prospective cohort study. SETTING: Intensive care unit (ICU) of a high-complexity hospital from November 2015 to October 2016. PATIENTS: Adults who were hospitalized for at least 72h in the ICU were followed from their admission to the ICU until their departure. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In the 157 patients followed up, the incidence of constipation was 75.8%. The univariate analysis showed that constipated patients were younger, used more sedation and showed more respiratory and postoperative causes for hospitalization, while non-constipated patients were hospitalized more for gastrointestinal reasons. The use of vasoactive substances, mechanical ventilation and haemodialysis was similar between the constipated and non-constipated patients. Multivariate analysis, days of use of docusate+bisacodyl (HR: .79; 95% CI: .65-.96) of omeprazole or ranitidine (HR: .80; 95%CI: .73-.88) and lactulose (HR: .87; 95%CI: .76-.99) were independent protection factors for constipation. CONCLUSION: Constipation has a high incidence among adult critical care patients. Days of drug use acting on the digestive tract (lactulose, docusate+bisacodyl and omeprazole and/or ranitidine) are able to prevent this outcome.