Department of Surgery, Pori City Hospital, Pori, Finland.
Drugs Aging. 2009;26(11):963-71. doi: 10.2165/11317660-000000000-00000.
Concomitant use of several medications for somatic and mental disorders is common in elderly people and increases the risk of falls, with hip fracture being the most serious consequence.
The objective of this study was to describe relationships between use of sedatives, antipsychotics or potent anticholinergics and postoperative mortality in patients with hip fractures.
A retrospective analysis was conducted on population-based data collected during a 2-year period from 1999 to 2000 on 461 hip fracture surgery patients aged > or = 65 years in Finland. Information on co-morbidities and intake of sedatives, antipsychotics and potent anticholinergics was obtained from the original patient records. Information on deaths was obtained from the official death statistics in Finland.
In men, use of potent anticholinergics was associated with excess age-adjusted mortality at 30 days, 3 months, 6 months and 3 years, but not in women at any timepoint.
Use of potent anticholinergic drugs emerged as an independent predictor of excess mortality in men at 3 months and 3 years. Presence of cardiovascular disease and chronic lung disease were independent risk factors for excess mortality at 6 months and 3 years in men. In addition, chronic lung disease independently predicted excess mortality at 30 days. Use of potent anticholinergics should be evaluated critically after hip fracture surgery, especially in men with cardiovascular or chronic lung diseases.
老年人同时使用多种药物治疗躯体和精神障碍较为常见，这会增加跌倒的风险，而髋部骨折是最严重的后果。
本研究旨在描述使用镇静剂、抗精神病药或强效抗胆碱能药物与髋部骨折患者术后死亡率之间的关系。
对芬兰在 1999 年至 2000 年期间，2 年时间内收集的 461 名年龄≥65 岁的髋部骨折手术患者的基于人群的数据进行回顾性分析。从原始病历中获取合并症和镇静剂、抗精神病药和强效抗胆碱能药物使用情况的信息。从芬兰官方死亡统计数据中获取死亡信息。
在男性中，使用强效抗胆碱能药物与 30 天、3 个月、6 个月和 3 年时的校正年龄死亡率过高有关，但在女性中任何时间点均无此关联。
在男性中，使用强效抗胆碱能药物 3 个月和 3 年时是死亡率过高的独立预测因素。心血管疾病和慢性肺部疾病的存在是男性 6 个月和 3 年时死亡率过高的独立危险因素。此外，慢性肺部疾病独立预测 30 天时的死亡率过高。髋部骨折手术后应仔细评估使用强效抗胆碱能药物的情况，尤其是患有心血管疾病或慢性肺部疾病的男性。
