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Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation

BACKGROUND/AIMS: Distinction is vague between severe constipation and postoperative ileus (POI) in terms of pathogenesis, clinical features, and treatment options. However, no data are available regarding their associations. METHODS: After retrospective review of data from patients who underwent ort...

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Autores principales: Lee, Tae Hee, Lee, Joon Seong, Hong, Su Jin, Jang, Jae Young, Jeon, Seong Ran, Byun, Dong Won, Park, Won Young, Kim, Soon Im, Choi, Hyung Suk, Lee, Jae Chul, Lee, Ji Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Neurogastroenterology and Motility 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288089/
https://www.ncbi.nlm.nih.gov/pubmed/25537675
http://dx.doi.org/10.5056/jnm14077
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author Lee, Tae Hee
Lee, Joon Seong
Hong, Su Jin
Jang, Jae Young
Jeon, Seong Ran
Byun, Dong Won
Park, Won Young
Kim, Soon Im
Choi, Hyung Suk
Lee, Jae Chul
Lee, Ji Sung
author_facet Lee, Tae Hee
Lee, Joon Seong
Hong, Su Jin
Jang, Jae Young
Jeon, Seong Ran
Byun, Dong Won
Park, Won Young
Kim, Soon Im
Choi, Hyung Suk
Lee, Jae Chul
Lee, Ji Sung
author_sort Lee, Tae Hee
collection PubMed
description BACKGROUND/AIMS: Distinction is vague between severe constipation and postoperative ileus (POI) in terms of pathogenesis, clinical features, and treatment options. However, no data are available regarding their associations. METHODS: After retrospective review of data from patients who underwent orthopedic surgery during the first 6 months of 2011, a total of 612 patients were included. Severe constipation was defined as symptoms of constipation requiring treatment using at least 2 laxatives from different classes for at least 6 months. POI was defined as paralytic ileus lasting more than 3 days post-surgery and associated with 2 or more of the following: (1) nausea/vomiting, (2) inability to tolerate an oral diet over a 24-hour period, and (3) absence of flatus over a 24-hour period. The subjects were divided into non-POI and POI groups, and we compared patient-, surgery-, and pharmaceutical-related factors. RESULTS: Thirteen (2.1%) out of 612 experienced POI. In comparisons between the non-POI and POI groups, univariate analysis showed significant differences in the mean age (51.4 vs 71.6 years), mean body mass index (24.1 vs 21.8 kg/m(2)), severe constipation (5.8% vs 76.9%), co-morbidities (33.2% vs 84.6%), type of orthopedic surgery (spine/hip/limb: 19.4/11.0/65.6% vs 23.1/61.5/15.4%), and estimated blood loss (50 vs 300 mL). Multivariate logistic regression analysis, after adjustment for age, body mass index, co-morbidities, type of orthopedic surgery, and estimated blood loss, showed that severe constipation was an independent risk factor for POI (OR, 35.23; 95% CI, 7.72–160.82; P < 0.001). CONCLUSIONS: Severe constipation is associated with POI after orthopedic surgery.
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spelling pubmed-42880892015-01-09 Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation Lee, Tae Hee Lee, Joon Seong Hong, Su Jin Jang, Jae Young Jeon, Seong Ran Byun, Dong Won Park, Won Young Kim, Soon Im Choi, Hyung Suk Lee, Jae Chul Lee, Ji Sung J Neurogastroenterol Motil Original Article BACKGROUND/AIMS: Distinction is vague between severe constipation and postoperative ileus (POI) in terms of pathogenesis, clinical features, and treatment options. However, no data are available regarding their associations. METHODS: After retrospective review of data from patients who underwent orthopedic surgery during the first 6 months of 2011, a total of 612 patients were included. Severe constipation was defined as symptoms of constipation requiring treatment using at least 2 laxatives from different classes for at least 6 months. POI was defined as paralytic ileus lasting more than 3 days post-surgery and associated with 2 or more of the following: (1) nausea/vomiting, (2) inability to tolerate an oral diet over a 24-hour period, and (3) absence of flatus over a 24-hour period. The subjects were divided into non-POI and POI groups, and we compared patient-, surgery-, and pharmaceutical-related factors. RESULTS: Thirteen (2.1%) out of 612 experienced POI. In comparisons between the non-POI and POI groups, univariate analysis showed significant differences in the mean age (51.4 vs 71.6 years), mean body mass index (24.1 vs 21.8 kg/m(2)), severe constipation (5.8% vs 76.9%), co-morbidities (33.2% vs 84.6%), type of orthopedic surgery (spine/hip/limb: 19.4/11.0/65.6% vs 23.1/61.5/15.4%), and estimated blood loss (50 vs 300 mL). Multivariate logistic regression analysis, after adjustment for age, body mass index, co-morbidities, type of orthopedic surgery, and estimated blood loss, showed that severe constipation was an independent risk factor for POI (OR, 35.23; 95% CI, 7.72–160.82; P < 0.001). CONCLUSIONS: Severe constipation is associated with POI after orthopedic surgery. Korean Society of Neurogastroenterology and Motility 2015-01 /pmc/articles/PMC4288089/ /pubmed/25537675 http://dx.doi.org/10.5056/jnm14077 Text en © 2015 The Korean Society of Neurogastroenterology and Motility This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Tae Hee
Lee, Joon Seong
Hong, Su Jin
Jang, Jae Young
Jeon, Seong Ran
Byun, Dong Won
Park, Won Young
Kim, Soon Im
Choi, Hyung Suk
Lee, Jae Chul
Lee, Ji Sung
Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation
title Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation
title_full Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation
title_fullStr Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation
title_full_unstemmed Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation
title_short Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation
title_sort risk factors for postoperative ileus following orthopedic surgery: the role of chronic constipation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288089/
https://www.ncbi.nlm.nih.gov/pubmed/25537675
http://dx.doi.org/10.5056/jnm14077
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