Background: Constipation is a common pediatric complaint and cause of abdominal pain in the pediatric age group. Management for constipation is generally completed in the outpatient setting, but many patients may require inpatient management after failure of outpatient therapy.
Methods: We utilized data from the 2012 Kids’ Inpatient Database (KID), a nationally representative sample of pediatric discharges. We included records with a primary diagnosis of constipation, fecal impaction, or encopresis. Variables for analysis included characteristics of the hospitalization (length of stay, total charges, procedures completed, whether the patient was transferred) as well as patient characteristics (presence of chronic conditions, sex, and source of payment for the hospitalization). Analysis was completed with SAS 9.3 using appropriate procedures to account for the complex survey design.
Results: There was a national estimate of 15, 057 discharges with a primary diagnosis of constipation. Four percent of these discharges had a major procedure in the operating room and mortality was rare (0.04%). Length of stay was 2.42 days (95% CI 2.34-2.51) with average charges of $14,485 (95% CI, 13,353-15,616). Patients with a primary diagnosis of constipation were more likely to have a chronic condition compared to the general inpatient population (57.5% vs 31.8%, p<0.0001) and had procedures less commonly (34.3% vs 58.0%, p<0.0001). Hospitalizations for constipation were more likely to have a payment source of Medicaid that for those of the general inpatient population (51.9% vs 49.2%, p=0.004). There were no differences in proportion of constipation admissions across regions of the country.
Conclusions: Although constipation is often treated in the outpatient setting, there are still many admissions with constipation as a primary diagnosis. Further research should explore the necessity of inpatient management, especially for the majority of admissions in this sample with no procedures performed during the admission.