College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Gyeonggi-do, Republic of Korea.
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
BMC Pharmacol Toxicol. 2021 Jan 7;22(1):2. doi: 10.1186/s40360-020-00467-6.
Considering the limited generalizability of previous anticholinergic burden scales, the Korean Anticholinergic Burden Scale (KABS) as a scale specific to the Korean population was developed. We aimed to validate the KABS by detecting the associations between high anticholinergic burden, measured with the KABS, and emergency department (ED) visits compared to the pre-existing validated scales in older Korean adults.
A nested case-control study was conducted using national claims data. The cases included the first anticholinergic ED visits between July 1 and December 31, 2016. Anticholinergic ED visits were defined as ED visits with a primary diagnosis of constipation, delirium, dizziness, fall, fracture, or urinary retention. Propensity score-matched controls were identified. Average daily AB scores during 30 days before the index date were measured. Multivariate logistic regression analyses were performed.
In total, 461,034 were included. The highest proportion of those with high AB was identified with KABS (5.0%). Compared with those who had a KABS score of 0, older adults with a score ≥ 3 were at higher risk for overall anticholinergic ED visits (aOR, 1.62, 95% CI, 1.53-1.72), as well as visits for falls/fractures (aOR: 1.54, 95% CI: 1.40-1.69), dizziness (aOR: 1.44, 95% CI: 1.30-1.59), delirium (aOR: 2.96, 95% CI: 2.28-3.83), constipation (aOR: 1.84, 95% CI: 1.68-2.02), and urinary retention (aOR: 2.13, 95% CI: 1.79-2.55). High AB by KABS showed a stronger association with overall anticholinergic ED visits and visits due to delirium and urinary retention than those by other scales.
In conclusion, KABS is superior to pre-existing scales in identifying patients with high AB and predicting high AB-related ED visits in older Korean adults.
考虑到先前的抗胆碱能负担量表的通用性有限，因此开发了一种特定于韩国人群的韩国抗胆碱能负担量表（KABS）。我们旨在通过检测 KABS 测量的高抗胆碱能负担与老年韩国人急诊就诊之间的关联来验证 KABS，与以前验证过的量表相比。
使用全国索赔数据进行嵌套病例对照研究。病例包括 2016 年 7 月 1 日至 12 月 31 日期间首次出现抗胆碱能急诊就诊的患者。抗胆碱能急诊就诊定义为因便秘、谵妄、头晕、跌倒、骨折或尿潴留而就诊的急诊就诊。确定了倾向评分匹配的对照组。测量指数日期前 30 天的平均每日 AB 评分。进行了多变量逻辑回归分析。
共有 461,034 人被纳入研究。具有高 AB 的人比例最高的是 KABS（5.0%）。与 KABS 得分为 0 的人相比，得分≥3 的老年人因总体抗胆碱能急诊就诊（OR：1.62，95%CI：1.53-1.72）以及因跌倒/骨折就诊的风险更高（OR：1.54，95%CI：1.40-1.69）、头晕（OR：1.44，95%CI：1.30-1.59）、谵妄（OR：2.96，95%CI：2.28-3.83）、便秘（OR：1.84，95%CI：1.68-2.02）和尿潴留（OR：2.13，95%CI：1.79-2.55）。KABS 中的高 AB 与其他量表相比，与总体抗胆碱能急诊就诊以及谵妄和尿潴留相关的就诊有更强的关联。
总之，KABS 优于以前的量表，可用于识别高 AB 患者并预测老年韩国人高 AB 相关的急诊就诊。
