title: Faecal impaction: in-hospital complications and their predictors in a retrospective study on 130 patients.
abstract: OBJECTIVE
  Faecal impaction may be a medical emergency. The frequency of complications of this condition and their predictors are not known. We determined the clinical presentation, the in-hospital complications and their predictors in 130 patients diagnosed with faecal impaction.
  
  
  METHODS
  This was a retrospective study of the medical records of 130 patients who presented with faecal impaction to a tertiary care center in Beirut, Lebanon, between 1992 and 2009. The clinical outcome and complications were reviewed. The association between in-hospital complications and other variables was determined.
  
  
  RESULTS
  The mean age of the patients was 67.1 years. Ninety-eight (75.3%) patients had at least one of the following: heart disease (36.3%), neurological disease (28.8%) or diabetes (22.6%), and 26.7% were bedridden. The site of impaction was the rectum in 66.4%. The patients were treated by manual disimpaction (34.5%), enema (89.1%) or oral laxatives (84.0%). A delay in treatment of more than 6 h occurred in 70 (53.8%) patients. In-hospital complications occurred in 34 (24.6%) patients, the most common of which were infectious (16 cases), systemic inflammatory response syndrome (16 cases), cardiopulmonary (14 cases) and death (one patient). Time to the start of treatment was longer in patients who developed complications compared with those who did not (10.1 h vs 7.1 h; P = 0.02). Patients > 80 years of age, or patients with heart or neurological disease were at a higher risk of developing complications (P = 0.03, P = 0.03 and P = 0.02, respectively).
  
  
  CONCLUSIONS
  Treatment delay, increasing age and the presence of heart or neurological disease seem to be predictors of in-hospital complications in patients with faecal impaction.
authors.affiliation: Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Houssam M
authors.initials: HM
authors.lastname: Halawi
authors.forename: Karim A
authors.initials: KA
authors.lastname: Maasri
authors.forename: Fadi H
authors.initials: FH
authors.lastname: Mourad
authors.forename: Kassem A
authors.initials: KA
authors.lastname: Barada
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004733:Enema; D005244:Fecal Impaction / Q000150:complications* / Q000628:therapy; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000150:complications*; D054368:Laxatives / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications*; D013997:Time Factors; D055815:Young Adult
chemical_list: D054368:Laxatives