Incidence of constipation in stroke patients: A systematic review and meta-analysis

Abstract

There is growing awareness of a link between the gut and cardiovascular disease. Constipation is common among individuals who have had a stroke, and it negatively affects social functioning and quality of life. However, no systematic study on the incidence of constipation in stroke patients has been reported.We selected studies included in Medline, Embase, Cochrane database, and Web of Science. Studies were included if they reported the incidence in stroke patients. Two authors selected the studies, extracted the data independently, and assessed these. Subgroup analyses were conducted according to the stroke subtype and stage of stroke.After detailed evaluations, 8 studies (n = 1385 participants) were found that contained data that were suitable for meta-analytic synthesis. A forest plot showed that the incidence of constipation was 48% (95% confidence interval [CI] = 33%-63%). In the analysis of the type of stroke subgroup, the incidence of constipation in patients who had had a hemorrhagic stroke (66% [95% CI = 40-91%]) was higher than that in patients who had experienced an ischemic stroke (51% [95% CI = 27%-75%]). The incidence in the acute stage (45% [95% CI = 36%-54%]) was lower than that in the rehabilitation stage (48% [95% CI = 23%-73%]).Constipation after a stroke event occurs frequently. This finding may raise awareness about bowel complications to allow correct evaluation and proper management.

Figure 1

Flow diagram of literature search. Flow diagram of the study selection process.

Figure 2

Incidence of constipation in stroke patients. The forest plot of incidence of constipation in stroke patients.

Figure 3

Incidence of constipation in the stroke subtype. The forest plots of incidence of constipation in the stroke subtype. (A) The forest plot of incidence of constipation in ischemic stroke patients. (B) The forest plot of incidence of constipation in hemorrhagic stroke patients.

Figure 4

Incidence of constipation in different stage of stroke. The forest plots of incidence of constipation in different stage of stroke. (A) The forest plot of incidence of constipation in acute stage of stroke. (B) The forest plot of incidence of constipation in rehabilitation stage of stroke.