S1140 Prevalence, Clinical Characteristics, and Healthcare Outcomes of Non-Obstructive Constipation Subtypes in Patients With Cerebral Palsy: A Nationwide Inpatient Analysis

Introduction: Patients with neurological disorders, such as cerebral palsy (CP), face an increased risk of gastrointestinal dysfunction, particularly constipation. Despite its clinical impact, limited data exist comparing constipation subtypes in this population. This study evaluates the prevalence and outcomes, including mortality, length of stay (LOS), and hospital charges, across 3 constipation subtypes: Ogilvie/paralytic ileus, functional constipation, and neurogenic bowel, in CP patients. Methods: Using the National Inpatient Sample (NIS) from 2018-2021, we identified CP patients with constipation using International Classification of Diseases-10-CM codes. Constipation was categorized into Ogilvie/paralytic ileus, functional constipation, and neurogenic bowel. T-test and chi-square test compared patient and hospital characteristics, while regression models assessed outcomes. Survey weights were applied to account for NIS's complex sampling design. Results: CP represented 367,785 hospitalizations; 9,795 had non-obstructive constipation. Functional constipation was the most common subtype (56.3%), followed by Ogilvie/paralytic ileus (35.6%) and neurogenic bowel (8.1%). CP patients with constipation were more likely to be White (61.4%), male (56.8%), on Medicaid (47.5%), and treated at large urban teaching hospitals (89.0%). Functional constipation had lower odds of in-hospital mortality (OR: 0.26, P = 0.003) compared to patients without constipation, while Ogilvie/paralytic ileus and neurogenic bowel had no significant impact on mortality. However, LOS increased with Ogilvie/paralytic ileus (β: +4.5, P < 0.001), neurogenic bowel (β: +3.3, P < 0.001), and functional constipation (β: +1.7, P < 0.001). Hospital charges were only higher in Ogilvie/paralytic ileus (β: +$59,992, P < 0.001), and neurogenic bowel (β: +$63,760, P < 0.001) groups. Conclusion: Non-obstructive constipation poses a significant burden for CP patients, with certain subtypes leading to prolonged LOS and higher costs. Early identification and interventions, such as dietary counseling and pelvic floor rehabilitation, may improve outcomes. Incorporating these strategies can reduce healthcare utilization and improve overall well-being for these patients. On the other hand, the observed reduction in mortality among CP patients with functional constipation may reflect increased healthcare engagement or a less severe disease profile compared to other subtypes. Further studies are warranted to explore these associations. AI was used to refine language only.