title: Inpatient burden of constipation in the United States: an analysis of national trends in the United States from 1997 to 2010.
abstract: OBJECTIVE
  Constipation is one of the most common outpatient diagnoses in primary care and gastroenterology clinics; however, there is limited data on the inpatient burden of constipation in the United States. The aim of this study was to evaluate inpatient admission rates, length of stay, and associated costs related to constipation from 1997 to 2010.
  
  
  METHODS
  We analyzed the National Inpatient Sample Database for all patients in which constipation (ICD-9 codes: 564.0-564.09) was the principal discharge diagnosis from 1997 to 2010. The statistical significance of the difference in the number of hospital discharges, length of stay, and hospital costs over the study period was determined by utilizing the Spearman's coefficient to describe various trends.
  
  
  RESULTS
  Between 1997 and 2010, the number of hospitalizations for patients with a primary discharge diagnosis of constipation increased from 21,190 patients to 48,450 (P<0.001, GoF test), whereas the mean length of hospital stay increased only slightly from 3.0 days to 3.1 days (b=0.008 (0.003-0.014); P=0.004). The mean charges per hospital discharge for constipation increased from $8869 in 1997 (adjusted for long-term inflation) to $17,518 in 2010 (b=745.4 (685.3-805.6); P<0.001)), whereas the total costs increased from $188,109,249 (adjusted for inflation) in 1997 to $851,713,263 in 2010. Although the elderly (65-84 years) accounted for the largest percentage of constipation discharges, patients in the 1-17 years age group had the highest frequency of constipation per 10,000 discharges.
  
  
  CONCLUSIONS
  The number of inpatient discharges for constipation and associated costs has significantly increased between 1997 and 2010.
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sethi
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Sage
authors.initials: S
authors.lastname: Mikami
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: John
authors.initials: J
authors.lastname: Leclair
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Park
authors.affiliation: Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Mike
authors.initials: M
authors.lastname: Jones
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Wadhwa
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Sethi
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Cheng
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Friedlander
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bollom
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lembo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003248:Constipation / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics* / Q000639:trends; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics* / Q000639:trends; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000191:economics* / Q000639:trends; D016012:Poisson Distribution; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D014481:United States