First defaecation and use of laxatives after hip fracture surgery.

INTRODUCTION

Patients undergoing hip fracture surgery are at risk of developing constipation post-operatively. This study investigated time to first defaecation after surgery.

METHODS

This retrospective cohort study included patients undergoing hip fracture surgery at a regional hospital from 1 May to 30 September 2024. Patients underwent a standardised hip fracture regimen, focusing on surgery within 24 hours of admission, early mobilisation, optimised medication including dual-drug laxatives, and daily geriatric post-operative rounds. Data were obtained from patient files after prospective data entry by the nursing staff, who were instructed on correct registration during the study period.

RESULTS

We included 102 patients (64% women), with a median age of 83 years (IQR: 76-88 years). The mean time to defaecation after surgery was 2.7 days (SD: 1.5 days). In 24% of the patients, first defaecation occurred later than three days post-operatively. Time to defaecation correlated with length of hospital stay (r = 0.22; 95% CI: 0.04-1.5; p = 0.04). No difference in time to defaecation was observed between patients who were mobilised before or after post-operative day three (p = 0.91). Overall, 66 patients (65%) received laxatives beyond the standard regimen.

CONCLUSIONS

Despite being treated with a contemporary, dedicated hip fracture regimen, post-operative delayed defaecation remains a frequent problem, and patients often require additional laxatives. This finding highlights a need to optimise post-operative constipation in hip fracture patients.

FUNDING: None.

TRIAL REGISTRATION: Approved by the Central Denmark Region.