Clinical Characteristics of Children Needing Inpatient Treatment after Failed Outpatient Treatment for Fecal...

Area of Science:

• Pediatric Gastroenterology
• Clinical Pediatrics
• Child Health Outcomes

Background:

• Chronic constipation and fecal impaction in children often require intensive outpatient laxative treatment.
• A subset of children fail outpatient management, necessitating hospitalization for treatment.
• Predicting which children will fail outpatient treatment is crucial for resource allocation and timely intervention.

Purpose of the Study:

• To compare the characteristics of children with chronic constipation who failed outpatient treatment and required hospitalization versus those successfully treated as outpatients.
• To identify specific attributes associated with a higher likelihood of hospitalization for pediatric constipation.

Main Methods:

• Retrospective cohort study of pediatric patients (0-21 years) with chronic functional constipation and fecal impaction.
• Analysis of medical records over a two-year period.
• Comparison of demographic and clinical factors between hospitalized (inpatient) and successfully treated (outpatient) groups.

Main Results:

• Out of 188 patients, 30.9% required hospitalization, while 69.2% were treated successfully as outpatients.
• Inpatient group characteristics included earlier age at onset (3.6 years), black ethnicity (OR 4.31), prematurity (OR 2.39), developmental delay (OR 2.20), overflow incontinence (OR 2.26), picky eating (OR 2.02), more ROME III criteria (median 4), and more prior constipation encounters (13.7).
• These factors were significantly associated with treatment failure and hospitalization.

Conclusions:

• Specific patient characteristics are associated with a higher risk of hospitalization for chronic constipation.
• Early identification of these risk factors can aid in anticipating treatment challenges.
• This may lead to more proactive management strategies to prevent hospitalization.