Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Department of Hospital Pharmacy, Franciscus Gasthuis & Vlietland, Rotterdam & Schiedam, the Netherlands.
Clin Interv Aging. 2022 Mar 15;17:277-285. doi: 10.2147/CIA.S357818. eCollection 2022.
In-hospital falls, especially among older patients, are a major and underestimated problem. Several studies have suggested a possible association between anticholinergic drug use and falls, but the results are inconclusive and studies focusing on in-hospital falls are scarce. The aim of the present study was to investigate whether anticholinergic drug exposure on admission is associated with in-hospital falls.
This retrospective chart review study was conducted in the Erasmus MC University Medical Center, Rotterdam, the Netherlands. Patients aged 65 years and older, who were acutely admitted to the geriatric ward between 2012 and 2015, were included. Anticholinergic drug exposure was determined with the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden scale (ACB) and the list of Chew. Logistic regression was used to investigate the possible association between anticholinergic drug exposure and in-hospital falls. Analyses were adjusted for age, sex, fall history, fall as reason for admission, number of drugs on admission, use of a mobility aid and delirium.
A total of 905 patients were included, of which 94 patients experienced one or more in-hospital falls. Each additional anticholinergic drug in use, according to the ARS, was associated with an increased odd of experiencing a fall (OR = 1.49, 95% CI: 1.06-2.10). Other measures, ie anticholinergic drug use (yes/no) and different categories of anticholinergic drug burden, measured with the ARS, ACB and list of Chew, were all not associated with in-hospital falls.
Anticholinergic drug exposure on admission is possibly not a main risk factor for in-hospital falls among older patients.
住院患者，尤其是老年患者，跌倒问题较为严重且被低估。一些研究表明，抗胆碱能药物的使用与跌倒之间可能存在关联，但结果尚无定论，且针对住院患者跌倒的研究较少。本研究旨在探讨入院时抗胆碱能药物暴露与院内跌倒的关系。
这是一项在荷兰鹿特丹伊拉斯谟医学中心进行的回顾性图表审查研究。纳入 2012 年至 2015 年期间因急性疾病入住老年病房且年龄在 65 岁及以上的患者。抗胆碱能药物暴露情况通过抗胆碱能风险量表（ARS）、抗胆碱能认知负担量表（ACB）和 Chew 清单进行评估。使用逻辑回归分析抗胆碱能药物暴露与院内跌倒之间的可能关联。分析调整了年龄、性别、跌倒史、跌倒入院原因、入院时用药数量、使用助行器和谵妄情况。
共纳入 905 例患者，其中 94 例发生了 1 次或多次院内跌倒。根据 ARS，每增加一种使用的抗胆碱能药物，发生跌倒的可能性就会增加（OR = 1.49，95%CI：1.06-2.10）。其他措施，即抗胆碱能药物使用（是/否）以及 ARS、ACB 和 Chew 清单测量的不同类别的抗胆碱能药物负担，与院内跌倒均无相关性。
入院时抗胆碱能药物暴露可能不是老年患者院内跌倒的主要危险因素。
