Use of Drugs with Anticholinergic Properties at Hospital Admission Associated with Mortality in Older Patients: A Danish Nationwide Register-Based Cohort Study

Søren Ramsdal Sørensen, Jeppe Dalskov Frederiksen, Pavithra Laxsen Anru, Tahir Masud, Mirko Petrovic, Jens Ulrik Rosholm, Jesper Ryg*

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

Background: Use of drugs with anticholinergic properties (DAP) has a negative impact on older people. Objective: Our aim was to examine the association between DAP at hospital admission and mortality in older patients. Patients and Methods: We performed a nationwide population-based cohort study including patients aged ≥ 65 years admitted to Danish geriatric medicine departments during 2005–2014. National health registers were used to link with individual-level data. Patients were followed to emigration, death, or study termination (31 December 2015). DAP was defined as medications included in the anticholinergic cognitive burden (ACB) scale, which assigns each DAP a score between 1 and 3. The individual ACB score was calculated and the number of DAP counted. We used Cox proportional-hazard regressions to estimate the crude and adjusted hazard ratios adjusting for age, activities of daily living, marital status, index admission period, BMI, and prior hospitalizations (model 1), and additionally Charlson Comorbidity Index (model 2). Results: We included 74,589 patients aged (median [IQR]) 83 (77–88) years. Use of one or more DAP (62.5%) was associated with increased mortality compared with those with no use (p < 0.001). In the fully adjusted model 2, compared with no use, higher mortality risks (HR [95% CI]) were seen with ACB score of 2 and number of DAP ≥ 5 for 30-day (1.46 [1.32–1.61] and 1.46 [1.09–1.95]), 1-year (1.34 [1.28–1.41] and 1.48 [1.29–1.70]), and overall mortality (1.27 [1.23–1.31] and 1.44 [1.31–1.59]), respectively. Conclusions: Use of DAP at hospital admission is associated with short- and long-term mortality in geriatric patients. Deprescribing studies are warranted to study whether the impact on mortality can be attenuated.

OriginalsprogEngelsk
TidsskriftDrugs - Real World Outcomes
ISSN2199-1154
DOI
StatusE-pub ahead of print - 19. aug. 2021

Bibliografisk note

Funding Information:
This work was supported by the Program for Clinical Research Infrastructure (PROCRIN) established by the Lundbeck Foundation and the Novo Nordisk Foundation [Grant number: R3-017]. The funders were not involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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