Faecal impaction: in-hospital complications and their predictors in a retrospective study on 130 patients

Aim Faecal impaction may be a medical emergency. The frequency of complications of this condition and their predictors are not known. We determined the clinical presentation, the in‐hospital complications and their predictors in 130 patients diagnosed with faecal impaction. Method This was a retro...

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Bibliographic Details
Published in:	Colorectal disease Vol. 14; no. 2; pp. 231 - 236
Main Authors:	Halawi, Houssam M., Maasri, Karim A., Mourad, Fadi H., Barada, Kassem A.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-02-2012
Subjects:	Adolescent Adult Age Factors Aged Aged, 80 and over Child complications Enema Faecal impaction Fecal Impaction - complications Fecal Impaction - therapy Female Heart Diseases - complications Hospitalization Humans Infection - complications Laxatives - therapeutic use Logistic Models Male Middle Aged Multivariate Analysis Nervous System Diseases - complications predictors Prognosis Retrospective Studies Systemic Inflammatory Response Syndrome - complications Time Factors Young Adult
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Summary:	Aim Faecal impaction may be a medical emergency. The frequency of complications of this condition and their predictors are not known. We determined the clinical presentation, the in‐hospital complications and their predictors in 130 patients diagnosed with faecal impaction. Method This was a retrospective study of the medical records of 130 patients who presented with faecal impaction to a tertiary care center in Beirut, Lebanon, between 1992 and 2009. The clinical outcome and complications were reviewed. The association between in‐hospital complications and other variables was determined. Results The mean age of the patients was 67.1 years. Ninety‐eight (75.3%) patients had at least one of the following: heart disease (36.3%), neurological disease (28.8%) or diabetes (22.6%), and 26.7% were bedridden. The site of impaction was the rectum in 66.4%. The patients were treated by manual disimpaction (34.5%), enema (89.1%) or oral laxatives (84.0%). A delay in treatment of more than 6 h occurred in 70 (53.8%) patients. In‐hospital complications occurred in 34 (24.6%) patients, the most common of which were infectious (16 cases), systemic inflammatory response syndrome (16 cases), cardiopulmonary (14 cases) and death (one patient). Time to the start of treatment was longer in patients who developed complications compared with those who did not (10.1 h vs 7.1 h; P = 0.02). Patients > 80 years of age, or patients with heart or neurological disease were at a higher risk of developing complications (P = 0.03, P = 0.03 and P = 0.02, respectively). Conclusion Treatment delay, increasing age and the presence of heart or neurological disease seem to be predictors of in‐hospital complications in patients with faecal impaction.
Bibliography:	ark:/67375/WNG-FZV1MD5R-M ArticleID:CODI2769 istex:53A91FB0A090133CCD6FBBF39F1EA63365A7ACCD This manuscript was presented as a poster at the United European Gastroenterology Week (London, UK, 21‐25 November 2009). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1462-8910 1463-1318
DOI:	10.1111/j.1463-1318.2011.02769.x