Constipation in patients undergoing cardiac surgery: Incidence and risk factors

Constipation following cardiac surgery is a frequently experienced complication in postoperative management. This study aimed to explore the incidence and risk factors for constipation after cardiac surgery.

We retrospectively analyzed data from 370 adult cardiac surgeries performed at our institution between January 2019 and December 2020. Postoperative constipation was defined as the absence of defecation for >144 hours after surgery. Participants were classified into a postoperative constipation or nonconstipation group. Multivariate logistic regression was performed to estimate the patient-specific perioperative factors associated with postoperative constipation.

A total of 72 (19.5%) patients developed postoperative constipation. Patients in the postoperative constipation group had higher rates of prolonged intubation (P < .001), higher 30-day mortality (P < .001), and longer intensive care unit stay (P < .001) than those in the nonconstipation group. Gastrointestinal complications were more common in the postoperative constipation group; however, the difference was not statistically significant (P = .087). Multivariate analysis demonstrated that peripheral artery disease (odds ratio [OR], 3.18; 95% CI, 1.23-8.24; P = .017), prior percutaneous coronary intervention (OR, 2.34; 95% CI, 1.12-4.89; P = .024), prolonged intubation (OR, 3.14; 95% CI, 1.35-7.29; P = .008), delayed nutrition (OR, 3.40; 95% CI, 1.13-10.26; P = .030), and vasopressin use (OR, 5.79; 95% CI, 1.38-14.52; P = .012) were independently predictive of postoperative constipation.

In patients undergoing cardiac surgery, 5 predictive risk factors for postoperative constipation were identified. Understanding these predictive factors will aid in direct risk assessments and the development of targeted treatments to prevent postoperative constipation.