The association between polypharmacy, anticholinergic burden, comorbidities, and hospital length of stay in geriatric patients

Avci G., Kanat B., Can G., Yavuzer H., Erdincler D., Döventaş A.

Medicine Science, cilt.12, sa.3, ss.661-666, 2023 (TRDizin) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 12 Sayı: 3
  • Basım Tarihi: 2023
  • Doi Numarası: 10.5455/medscience.2023.05.062
  • Dergi Adı: Medicine Science
  • Derginin Tarandığı İndeksler: TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.661-666
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

We aimed to evaluate the association between polypharmacy, anticholinergic burden, comorbidities, and hospital length of stay in older adults. We analyzed 213 older in-patient data retrospectively. Demographic data, comorbidities, length of stay, medication use, and laboratory results at admission were extracted from electronic medical records. We used a calculator to work out Anticholinergic Burden (ACB). The use of five or more drugs was considered polypharmacy. The mean age was 78±7.3 years; 54.5% of patients were female. The mean length of stay of patients was 20.7±13.8 days. The prevalence of polypharmacy was 66.2% (n:141), and 182 (85.4%) of the patients were treated with anticholinergic medications. 52.6% had high ACB scores (ACB score 3 and more). The most used drugs with anticholinergic potential were metoprolol (40.4%) and metformin (32.4%). Polypharmacy was identified as a risk factor for the presence of high ACB with 86% sensitivity and 55% specificity. (OR 0.758 95% CI: 0.692-0.824, p: <0.001). High ACB score was an independent risk factor for the presence of length of stay (OR: 1.19, 95% CI: 1.10-1.29, p: <0.001), diabetes mellitus (OR: 3.15, 95% CI: 1.08-9.18, p=0.035), coronary artery disease (OR: 5.32, 95% CI: 1.65-17.11, p=0.005), atrial fibrillation (OR: 4.94, 95% CI: 1.30-18.83, p=0.019), depression (OR: 10.96, 95% CI: 3.28-36.58, p: <0.001), psychotic disorder (OR: 80.53, 95% CI: 4.72-1372.05, p=0.002), Parkinson’s disease (OR: 3.65, 95% CI: 1.21-11.01, p=0.021), and rheumatological illness (OR: 5.89, 95% CI: 1.20-28.97, p=0.029). Polypharmacy, length of stay, and comorbidities such as cardiometabolic diseases (diabetes mellitus, coronary artery disease, atrial fibrillation), psychiatric and neurological disorders (depression, psychotic disorder, Parkinson's), and rheumatological illness are significantly associated with ACB. It is crucial to be aware of the ACB for rational drug use and optimum treatment of comorbidities to prevent adverse outcomes in older patients