Laxative use and 28-day mortality in critically ill sepsis patients: a retrospective cohort study using MIMIC-IV (v3.1)
Authors' conclusion
Docusate sodium appears to be a safer and more effective bowel management option for critically ill patients with sepsis. In contrast, the association between lactulose use and adverse outcomes may primarily reflect the severity of underlying liver disease rather than a direct drug effect.
Study context
- Population
- Critically ill ICU patients with sepsis (median age 67.5 years; 63% male), MIMIC-IV database
- Participants
- 7,163 patients
- Exposure
- Docusate Sodium, Polyethylene Glycol or Lactulose vs Senna
- Outcome
- 28-day mortality
- Follow-up
- 28 days
Methodological detailspropensity score matching, multivariable adjustment, MIMIC-IV database (v3.1)
- Propensity score matching
- Multivariable adjustment
- MIMIC-IV database (v3.1)
Main finding
As reported in the abstract
Each group vs sennaAdjusted hazard ratio (95% CI)
Docusate Sodium
0.43(0.36–0.52)
Lactuloselinked to higher mortality
1.82(1.45–2.27)
Observational data: associations, not effects.
Further findings
ICU-free days and bowel recovery
- More ICU-free days and better bowel recovery with Docusate Sodium vs Senna
- Fewer ICU-free days with Lactulose
Subgroups by sex, age and comorbidity (subgroup)
- Subgroup analyses confirmed these trends across sex, age and comorbidity strata
Original publication
Laxative use and 28-day mortality in critically ill sepsis patients: a retrospective cohort study using MIMIC-IV (v3.1). J Intensive Care. Published 21 May 2025. doi:10.
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