PMID- 24582945
OWN - NLM
STAT- MEDLINE
DCOM- 20141028
LR  - 20191210
IS  - 1872-6976 (Electronic)
IS  - 0167-4943 (Linking)
VI  - 59
IP  - 1
DP  - 2014 Jul-Aug
TI  - The relationship between total anticholinergic burden (ACB) and early in-patient 
      hospital mortality and length of stay in the oldest old aged 90 years and over 
      admitted with an acute illness.
PG  - 155-61
LID - S0167-4943(14)00007-7 [pii]
LID - 10.1016/j.archger.2014.01.006 [doi]
AB  - The use of prescription drugs in older people is high and many commonly 
      prescribed drugs have anticholinergic effects. We examined the relationship 
      between ACB on mortality and in-patient length of stay in the oldest old 
      hospitalised population. This was a retrospective analysis of prospective audit 
      using hospital audit data from acute medical admissions in three hospitals in 
      England and Scotland. Baseline use of possible or definite anticholinergics was 
      determined according to the Anticholinergic Cognitive Burden Scale. The main 
      outcome measures were decline in-hospital mortality, early in-hospital mortality 
      at 3- and 7-days and in-patient length of stay. A total of 419 patients 
      (including 65 patients with known dementia) were included [median age=92.9, 
      inter-quartile range (IQR) 91.4-95.1 years]. 256 (61.1%) were taking 
      anticholinergic medications. Younger age, greater number of pre-morbid 
      conditions, ischemic heart disease, number of medications, higher urea and 
      creatinine levels were significantly associated with higher total ACB burden on 
      univariate regression analysis. There were no significant differences observed in 
      terms of in-patient mortality, in-patient hospital mortality within 3- and 7-days 
      and likelihood of prolonged length of hospital stay between ACB categories. 
      Compared to those without cardiovascular disease, patients with cardiovascular 
      disease showed similar outcome regardless of ACB load (either =0 or >0 ACB). We 
      found no association between ACB and early (within 3- and 7-days) and in-patient 
      mortality and hospital length of stay outcomes in this cohort of oldest old in 
      the acute medical admission setting.
CI  - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved.
FAU - Kidd, Andrew C
AU  - Kidd AC
AD  - Norwich Medical School, Faculty of Medicine & Health Sciences, Chancellors Drive, 
      University of East Anglia, Norwich NR4 7TJ, Norfolk Island; Academic Department 
      of Medicine for the Elderly, Norfolk and Norwich University Hospital, Colney 
      Lane, Norwich NR4 7UY, Norfolk Island. Electronic address: 
      andrewcraigkidd@yahoo.co.uk.
FAU - Musonda, Patrick
AU  - Musonda P
AD  - Norwich Medical School, Faculty of Medicine & Health Sciences, Chancellors Drive, 
      University of East Anglia, Norwich NR4 7TJ, Norfolk Island.
FAU - Soiza, Roy L
AU  - Soiza RL
AD  - Academic Department of Medicine for the Elderly, Woodend Hospital, Eday Road, 
      Aberdeen AB15 6XS, Scotland, United Kingdom; School of Medicine & Dentistry, 
      Division of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, 
      United Kingdom.
FAU - Butchart, Catherine
AU  - Butchart C
AD  - Academic Department of Medicine for the Elderly, Woodend Hospital, Eday Road, 
      Aberdeen AB15 6XS, Scotland, United Kingdom.
FAU - Lunt, Claire J
AU  - Lunt CJ
AD  - Academic Department of Medicine for the Elderly, Woodend Hospital, Eday Road, 
      Aberdeen AB15 6XS, Scotland, United Kingdom.
FAU - Pai, Yogish
AU  - Pai Y
AD  - University Hospital of South Manchester, Manchester M23 9LT, United Kingdom.
FAU - Hameed, Yasir
AU  - Hameed Y
AD  - Norfolk & Waveney Mental Health Care Trust, Norwich NR6 5BE, United Kingdom.
FAU - Fox, Chris
AU  - Fox C
AD  - Norwich Medical School, Faculty of Medicine & Health Sciences, Chancellors Drive, 
      University of East Anglia, Norwich NR4 7TJ, Norfolk Island.
FAU - Potter, John F
AU  - Potter JF
AD  - Norwich Medical School, Faculty of Medicine & Health Sciences, Chancellors Drive, 
      University of East Anglia, Norwich NR4 7TJ, Norfolk Island; Academic Department 
      of Medicine for the Elderly, Norfolk and Norwich University Hospital, Colney 
      Lane, Norwich NR4 7UY, Norfolk Island.
FAU - Myint, Phyo Kyaw
AU  - Myint PK
AD  - Academic Department of Medicine for the Elderly, Woodend Hospital, Eday Road, 
      Aberdeen AB15 6XS, Scotland, United Kingdom; School of Medicine & Dentistry, 
      Division of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, 
      United Kingdom. Electronic address: phyo.myint@abdn.ac.uk.
LA  - eng
PT  - Journal Article
DEP - 20140205
PL  - Netherlands
TA  - Arch Gerontol Geriatr
JT  - Archives of gerontology and geriatrics
JID - 8214379
RN  - 0 (Cholinergic Antagonists)
SB  - IM
MH  - Acute Disease
MH  - Aged, 80 and over
MH  - Cholinergic Antagonists/*administration & dosage
MH  - England/epidemiology
MH  - Female
MH  - *Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Outcome Assessment, Health Care
MH  - Retrospective Studies
MH  - Scotland/epidemiology
OTO - NOTNLM
OT  - ACB
OT  - Length of stay
OT  - Mortality
OT  - Oldest old
EDAT- 2014/03/04 06:00
MHDA- 2014/10/29 06:00
CRDT- 2014/03/04 06:00
PHST- 2013/12/06 00:00 [received]
PHST- 2014/01/22 00:00 [revised]
PHST- 2014/01/25 00:00 [accepted]
PHST- 2014/03/04 06:00 [entrez]
PHST- 2014/03/04 06:00 [pubmed]
PHST- 2014/10/29 06:00 [medline]
AID - S0167-4943(14)00007-7 [pii]
AID - 10.1016/j.archger.2014.01.006 [doi]
PST - ppublish
SO  - Arch Gerontol Geriatr. 2014 Jul-Aug;59(1):155-61. doi: 
      10.1016/j.archger.2014.01.006. Epub 2014 Feb 5.