Department of Pharmacology, Chung Shan Medical University, Taichung 40201, Taiwan.
Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
Int J Environ Res Public Health. 2020 Aug 28;17(17):6260. doi: 10.3390/ijerph17176260.
Anticholinergic drugs may increase the risk of serious respiratory infection, especially in the elderly. The study aims to investigate the prevalence of anticholinergic drugs and the correlation of incident pneumonia associated with the use of anticholinergic drugs among the elderly in Taiwan. The study population was 275,005 elderly patients aged ≥65 years old, selected from the longitudinal health insurance database (LHID) in 2016. Among all the elderly patients, about 60% had received anticholinergic medication at least once. Furthermore, the study selected elderly patients who had not been diagnosed with pneumonia and had not received any anticholinergic drugs in the past year in order to evaluate the correlation between pneumonia and anticholinergic drugs. The study excluded elderly patients who died or had received related drugs of incident pneumonia during the study period and selected elderly patients receiving anticholinergic drugs as the case group. Propensity score matching (PSM) on a 1:1 scale was used to match elderly patients that were not receiving any anticholinergic drugs as the control group, resulting in a final sample of 32,215 patients receiving anticholinergic drugs and 32,215 patients not receiving any anticholinergic drugs. Conditional logistic regression was used to estimate the association between anticholinergic drugs and pneumonia after controlling for potential confounders. Compared with patients not receiving anticholinergic drugs, the adjusted odds ratio of patients receiving anticholinergic drugs was 1.33 (95% confidence interval: 1.18 to 1.49). Anticholinergic medication is common among elderly patients in Taiwan. Elderly patients receiving anticholinergic drugs may increase their risk of incident pneumonia. The safety of anticholinergic drugs in the elderly should be of concern in Taiwan.
抗胆碱能药物可能会增加严重呼吸道感染的风险，尤其是在老年人中。本研究旨在调查台湾老年人中抗胆碱能药物的使用情况以及与使用抗胆碱能药物相关的肺炎发生率，并探讨两者之间的相关性。研究人群为来自 2016 年纵向健康保险数据库（LHID）的 275005 名年龄≥65 岁的老年人。在所有老年人中，约 60%至少使用过一次抗胆碱能药物。此外，本研究选择了在过去一年中未被诊断患有肺炎且未使用过任何抗胆碱能药物的老年人，以评估肺炎与抗胆碱能药物之间的相关性。本研究排除了在研究期间死亡或患有相关肺炎药物的老年人以及接受相关肺炎药物治疗的老年人，并选择接受抗胆碱能药物治疗的老年人作为病例组。采用 1:1 比例的倾向评分匹配（PSM）对未接受任何抗胆碱能药物治疗的老年人进行匹配，得到最终样本 32215 例接受抗胆碱能药物治疗和 32215 例未接受任何抗胆碱能药物治疗的老年人。采用条件逻辑回归控制潜在混杂因素后，估计抗胆碱能药物与肺炎之间的关联。与未接受抗胆碱能药物治疗的患者相比，接受抗胆碱能药物治疗的患者调整后的优势比为 1.33（95%置信区间：1.18 至 1.49）。抗胆碱能药物在台湾老年人中较为常见。接受抗胆碱能药物治疗的老年人发生肺炎的风险可能会增加。台湾应关注抗胆碱能药物在老年人中的安全性。
