Risks Of Defecatory Dysfunction In Acute Minor Ischemic Stroke Patients

BackgroundPost-stroke defecation disorder was a common complication in stroke patients,but clinicians usually focused on the post-stroke defecation disorder in patients with severe stroke.It is believed that minor stroke patients had less neurological deficits and a better prognosis.However,In clinical,we have founded that many patients with minor stroke also had defecation disorders,which have affected the patient's neurological recovery.However,the occurrence and influencing factors of defecation disorder and its impact on the outcome of patients with minor stroke were not yet clear.ObjectiveTo study the incidence and risk factors of defecatory dysfunction in acute minor ischemic stroke patients and to explore the influence of the risk factors on prognosis.MethodsWe conducted a retrospective review of clinical data of 274 patients diagnosed with acute minor ischemic stroke at the First Affiliated Hospital of Soochow University between February 2015 and September 2016.According to the presence of post-stroke defecatory dysfunction,it was divided into defecatory dysfunction group and non-defecatory dysfunction group.Univariate and Multivariate logistic regression analysis was used to analyze factors associated with defecatory dysfunction respectively include gender,age,past history,baseline NIHSS score,stroke lesion location,medication,laboratory indexes.Then,to compare and analyze the factors associated with scores of modified Rankin after 3 months.Results1.74 patients of 274 patients with acute minor ischemic stroke had defecatory dysfunction with an incidence rate of 27.0%.In the 7 days after stroke,there were 52 cases accounting for 70.3%,7 to 14 days after stroke,a total of 16 cases,accounting for 21.6%,14 day after stroke,a total of 6 cases,accounting for 8.1%.2.The univariate analysis indicated that 5 factors including female,age?65,Diabetes mellitus,baseline NIHSS score and serum prealbumin levels were associated with defecation disorders after mild stroke The multivariate logistic analysis showed that female(OR 2.011,95%CI 1.094 ~ 3.697),higher age(OR 2.113,95%CI 1.124 ~3.972),Diabetes mellitus(OR 2.033,95%CI 1.097~3.766)and higher baselinee NIHSS score(OR 1.393,95%CI 1.145 ~ 1.694)were independent risk factors for defecatory dysfunction.3.The scores of modified Rankin Scale(m RS)after 3 months in minor stroke patients with defecatory dysfunction was higher significantly(P<0.05).Baseline NIHSS score(OR 1.935,95%CI 1.267 ~ 2.956)might affect the prognosis of post-stroke defecatory dysfunction patients.Conclusion1.The prevalence rate of post-stroke defecatory dysfunction was 27.0% in the study.The peak period of defecation disorder was 3 to 7 days after stroke.2.Female edlerly and those with diabetes mellitus and serious neurological function deficits were more likely to suffer post-stroke defecatory dysfunction.3.Defecatory dysfunction in acute minor stroke might increase the risk of poor prognosis.