Constipation prophylaxis reduces length of stay in elderly hospitalized heart failure patients with home laxative use

Background and Aim Elderly, hospitalized patients suffer disproportionately from constipation; however, little data suggest that constipation prophylaxis reduces length of stay ( LOS ). We performed a retrospective analysis of elderly patients admitted to our hospital with congestive heart failure ( CHF ) to determine the effects of constipation prophylaxis on LOS . Methods Patients ≥ 65 years old admitted with the diagnosis of CHF in 2012 were evaluated for home and hospital laxative use on admission. Our primary outcome was LOS . We used linear regression modeling to independently evaluate the impact of constipation prophylaxis on LOS . Results Among 618 patients who were eligible for our study, 201 (32.5%) were using laxatives at home, whereas 254 (41.1%) were started on a prophylactic laxative on admission. There was no significant difference in LOS between patients receiving prophylaxis versus those who did not ( P  = 0.32). Patients with home laxative use had a 1 day longer LOS compared to those without laxative use (6 vs 5, P  = 0.03). Among patients with home laxative use, there were 2 days longer LOS in those who were not given constipation prophylaxis on admission (8 vs 6, P  = 0.002). After multivariate adjustment, failure to use constipation prophylaxis in patients with home laxative use was the only independent predictor of increased LOS ( P  = 0.03). Conclusions Among elderly patients admitted for CHF exacerbations, failure to use constipation prophylaxis in patients with home laxative use is associated with a significantly longer LOS . Our data suggest that routine use of bowel prophylaxis for elderly CHF patients with preexisting constipation may reduce LOS .