Incidence, risk factors, and prognosis of constipation in acute ischemic stroke: A prospective, observational study

Background: Constipation is common in patients with acute ischemic stroke, yet its incidence and prognosis remain unknown. Herein, we investigate the incidence of new-onset constipation and its risk factors and relationship with stroke severity and prognosis. Methods: This prospective study enrolled 358 patients diagnosed with acute ischemic stroke. The Constipation Scoring System was used to assess new-onset constipation during hospitalization. Demographics, medical histories, clinical data, laboratory parameters, and medication use were compared between non-constipation and constipation groups. Univariate and multivariate logistic regression and multiple linear regression were used to explore potential influencing factors and prognosis. Results: The cumulative incidence of new-onset constipation during was 41.6 %. Its occurrence was closely associated with multiple demographic factors and laboratory markers. Binary logistic regression identified age (P = 0.002), eosinophil count (P = 0.004), and modified Rankin scale (mRS) scores at admission (P = 0.048) as significant predictors. The NIHSS ((3 = 0.179, P = 0.001) and mRS ((3 = 0.168, P = 0.016) scores at admission significantly positively predicted the Constipation Assessment Scale. NIHSS scores at admission ((3 = 0.300, P < 0.001) also positively predicted constipation severity at six-month follow-up. Conclusion: New-onset constipation is a common complication of acute ischemic stroke hospitalization. NIHSS, mRS, and water swallowing test scores at admission can predict the incidence and severity of constipation during hospitalization and at the 6-month follow-up. These findings provide clinical insights for early risk assessment and intervention to mitigate constipation-related complications in patients with stroke.