Incidence, risk factors, and prognosis of constipation in acute ischemic stroke: A prospective, observational study

Constipation is common in patients with acute ischemic stroke, yet its incidence and prognosis remain unknown. Herein, we investigate the incidence of new-onset constipation and its risk factors and relationship with stroke severity and prognosis.

This prospective study enrolled 358 patients diagnosed with acute ischemic stroke. The Constipation Scoring System was used to assess new-onset constipation during hospitalization. Demographics, medical histories, clinical data, laboratory parameters, and medication use were compared between non-constipation and constipation groups. Univariate and multivariate logistic regression and multiple linear regression were used to explore potential influencing factors and prognosis.

The cumulative incidence of new-onset constipation during was 41.6 %. Its occurrence was closely associated with multiple demographic factors and laboratory markers. Binary logistic regression identified age (P = 0.002), eosinophil count (P = 0.004), and modified Rankin scale (mRS) scores at admission (P = 0.048) as significant predictors. The NIHSS (β = 0.179, P = 0.001) and mRS (β = 0.168, P = 0.016) scores at admission significantly positively predicted the Constipation Assessment Scale. NIHSS scores at admission (β = 0.300, P < 0.001) also positively predicted constipation severity at six-month follow-up.

New-onset constipation is a common complication of acute ischemic stroke hospitalization. NIHSS, mRS, and water swallowing test scores at admission can predict the incidence and severity of constipation during hospitalization and at the 6-month follow-up. These findings provide clinical insights for early risk assessment and intervention to mitigate constipation-related complications in patients with stroke.