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(Stroke. 2009;40:1304.)
© 2009 American Heart Association, Inc.

Original Contributions

New-Onset Constipation at Acute Stage After First Stroke

Incidence, Risk Factors, and Impact on the Stroke Outcome

Yongjing Su, MSc; Xiaoyan Zhang, BS; Jinsheng Zeng, MD, PhD; Zhong Pei, MD, PhD; Raymond Tak Fai Cheung, MD, PhD; Qiuping (Pearl) Zhou, RN, PhD; Li Ling, MD, MSc; Jian Yu, MD, PhD; Jianling Tan, MSc Zhenlu Zhang

From the Department of Neurology and Stroke Center (Y.S., J.Z., Z.P., L.L., J.Y.) and the Nursing Department (X.Z., Z.Z.), First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; the Division of Neurology, Department of Medicine (R.T.F.C.), University of Hong Kong, and Comprehensive Acute Stroke Centre, Queen Mary Hospital, Hong Kong, China; the School of Nursing, College of Health and Human Services (Q.Z.), George Mason University, Fairfax, Va; and the Nursing College (J.T.), Sun Yat-Sen University, Guangzhou, China.

Correspondence to Jinsheng Zeng, MD, PhD, Department of Neurology and Stroke Center, the First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, PR China. E-mail zengjs{at}pub.guangzhou.gd.cn

Background and Purpose— The prevalence of constipation after stroke varies from 30% to 60%. The incidence of new-onset constipation during the early stage of stroke remains uncertain. The present study was designed to investigate the prevalence of new-onset constipation, its risk factors, and its impact on stroke outcome in patients with their first stroke at acute stage.

Methods— This is a prospective cohort study of 154 patients admitted with their first stroke. New-onset constipation during the first 4 weeks of stroke was recorded, using the Rome II criteria for constipation. Demographics, characteristics of the stroke, laboratory parameters, and use of medications were evaluated as risk factors for constipation. Death, recurrent stroke, and handicap at 12 weeks were regarded as poor outcome. The impact of constipation on poor outcome was also studied.

Results— The cumulative incidence of new-onset constipation was 55.2% at 4 weeks poststroke. The occurrence of constipation was associated with dependence (P<0.01) and use of bedpan for defecation (P<0.05). Among patients with moderate stroke severity (NIHSS 4 to11) at baseline, constipation at 4 weeks was associated with a poor outcome at 12 weeks.

Conclusions— New-onset constipation is a common complication of acute stroke. Its occurrence is associated with dependence and use of bedpan for defecation. Its development may predict a poor outcome at 12 weeks in patients with moderately severe stroke.

Key Words: stroke • constipation • incidence • risk factors • outcome