Department of Pulmonary and Critical Care Medicine, Shantou Central Hospital, Shantou, China.
Shantou University Medical College, Shantou, China.
Ann Med. 2023 Dec;55(1):2209736. doi: 10.1080/07853890.2023.2209736.
To conduct a meta-analysis and systematic review on the association between anticholinergic medication uses and the risk of pneumonia in elderly adults.
Medical databases were searched included PubMed, Web of Science, EBSCO and Google Scholar (up to December 7, 2022). Studies evaluating association between anticholinergic medication uses and the risk of pneumonia in elderly adults were included. Studies without available data were excluded. We made meta-analysis by using adjusted odds ratio (aOR) with 95% confidence intervals (CIs) from random-effects model. The risk of bias was assessed using ROBINS-I tool and statistical heterogeneity using the statistic. Registration: INPLASY202330070.
A total of six studies with 107,012 participants were included. Meta-analysis results showed that anticholinergic medication uses was related with an increased risk of pneumonia (aOR = 1.59; 95%CI, 1.32-1.92) and stroke-associated pneumonia (aOR = 2.02; 95%CI, 1.76-2.33). Moreover, risk estimates of pneumonia for high-potency anticholinergics (aOR = 1.96; 95%CI, 1.22-3.14) were higher than those for low-potency anticholinergics (aOR = 1.58; 95%CI, 1.27-1.97). And increased risk of pneumonia was associated with the anticholinergic medication uses within 30 days (aOR = 2.13; 95%CI, 1.33-3.43), within 90 days (aOR = 2.03; 95%CI, 1.26-3.26) and chronic use (aOR = 1.65; 95%CI, 1.09-2.51).
The risk of pneumonia is increased in elderly adults with anticholinergic medication, especially with higher-potency anticholinergic drugs and in the initiation phase of anticholinergic medication. Clinicians should monitor their use in older patients carefully, especially when the pneumonia-related signs and symptoms are identified.
对使用抗胆碱能药物与老年人肺炎风险之间的关系进行荟萃分析和系统评价。
检索了包括 PubMed、Web of Science、EBSCO 和 Google Scholar（截至 2022 年 12 月 7 日）在内的医学数据库。纳入了评估抗胆碱能药物使用与老年人肺炎风险之间关系的研究。排除了没有可用数据的研究。我们使用随机效应模型中的调整比值比（aOR）和 95%置信区间（CI）进行荟萃分析。使用 ROBINS-I 工具评估偏倚风险，并使用 Q 统计量评估统计异质性。注册：INPLASY202330070。
共有 6 项包含 107012 名参与者的研究纳入分析。荟萃分析结果表明，使用抗胆碱能药物与肺炎风险增加相关（aOR=1.59；95%CI，1.32-1.92）和卒中相关性肺炎（aOR=2.02；95%CI，1.76-2.33）。此外，高效能抗胆碱能药物（aOR=1.96；95%CI，1.22-3.14）所致肺炎的风险估计值高于低效能抗胆碱能药物（aOR=1.58；95%CI，1.27-1.97）。肺炎风险与 30 天内（aOR=2.13；95%CI，1.33-3.43）、90 天内（aOR=2.03；95%CI，1.26-3.26）和慢性使用（aOR=1.65；95%CI，1.09-2.51）的抗胆碱能药物使用相关。
老年人使用抗胆碱能药物会增加肺炎风险，尤其是使用高效能抗胆碱能药物和抗胆碱能药物起始阶段。临床医生应在老年患者中仔细监测抗胆碱能药物的使用，特别是在出现肺炎相关症状和体征时。
