Emergency department diagnosis and management of constipation in the United States, 2006–2017 - 16/03/22
Abstract |
Background |
Constipation is a common diagnosis in adults and children. Emergency department (ED) visits for constipation increased from 1980 to 2010. Since then, efforts have aimed to reduce resource utilization for constipation in the ED setting. Our objective is to examine contemporary ED practice patterns in the context of updated care guidelines.
Methods |
We conducted a cross-sectional study using the National Hospital Ambulatory Medical Care Survey from 2006 to 2017. Encounters with a constipation diagnosis were included. We examined rates of ED visits, diagnostic testing, and medication use. We also compared general and pediatric ED practice patterns for children.
Results |
Approximately 1.3 million ED visits with a diagnosis of constipation occurred annually, with pediatric encounters comprising one-third of all visits. There was a 114% increase in ED visits for constipation over the study period. Urinalysis and imaging increased by 17% and 15%, respectively. Older patients were more likely to undergo diagnostic testing. No significant changes in laboratory testing, radiographs, or osmotic laxative prescriptions were observed among children. Compared to pediatric EDs, general EDs were more likely to perform CBC (29% vs. 15%) and urinalysis testing (42% vs 31%). General EDs were less likely to prescribe osmotic laxatives for children compared to pediatric EDs (26% vs. 37%).
Conclusion |
ED visits for constipation have increased significantly since 2006. Rates of diagnostic tests and prescriptions have not changed despite published evidence and guidelines that the diagnosis of constipation does not require imaging, and that the management of constipation requires consistent outpatient treatment. Opportunities exist to reduce ED resource utilization through knowledge dissemination and implementation.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Constipation is a common complaint that is most often addressed in the outpatient setting. |
• | Emergency department (ED) constipation visits increased in the early 2000s, but current trends are unknown. |
• | Successful local efforts have decreased ED use and diagnostic testing for constipation. |
• | We found that constipation visits continued to increase significantly from 2006 to 2017. |
• | The use of diagnostic tests and treatments have not changed significantly over time. |
• | General EDs are more likely than pediatric EDs to perform diagnostic tests and less likely to prescribe osmotic laxatives. |
Keywords : Constipation, Emergency department, Diagnostic testing, Resource utilization
Plan
Vol 54
P. 91-96 - avril 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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