Chronic constipation in patients with acute heart failure is related to prognosis

Objectives.

To study whether chronic constipation (CC) in patients hospitalized for acute heart failure (AHF) is associated with short-term prognosis.

Methods.

Baseline and clinical data were prospectively collected for a cohort of patients consecutively admitted for AHF. CC was diagnosed if a patient reported having at least 2 of the following symptoms lasting at least 3 months within the past year: a) straining when emptying bowels, b) hard or lumpy stool, c) a feeling that bowels have not been fully emptied, d) a feeling of anorectal blockage, and e) fewer than 3 spontaneous bowel movements per week. We estimated crude and adjusted associations between CC and a composite outcome of 30-day mortality or readmission for AHF.

Results.

A total of 492 patients hospitalized for AHF were studied; 116 (23.6%) were diagnosed with CC on admission. The mean (SD) age was 64 (11) years for patients without CC and 65 (10) years for patients with CC. Patients with CC had higher prevalences of chronic kidney insufficiency, valvular heart disease, atrial fibrillation, and need for mechanical ventilation on admission. The Kaplan-Meier analyses before and after propensity score matching showed that risk for 30-day mortality or readmission for AHF was significantly greater in patients with CC (before, log-rank P < .001); after, log-rank P = .046).

Conclusions.

Poorer clinical outcomes were associated with CC in this cohort of patients with AHF.