Evidence map›Paper›PMID 28766100›Full record

ArticleEuropean journal of clinical pharmacology2017

Anticholinergic burden and health outcomes among older adults discharged from hospital: results from the CRIME study.

Marta Gutiérrez-Valencia, Nicolás Martínez-Velilla, Davide Liborio Vetrano, Andrea Corsonello, Fabrizia Lattanzio, Sergio Ladrón-Arana, Graziano Onder

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in European journal of clinical pharmacology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
2.1field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Pooled it
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  4. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Marta Gutiérrez-ValenciaDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Navarra, Spain. marta.guva@gmail.com.ORCID http://orcid.org/0000-0002-3229-6614
Nicolás Martínez-VelillaDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
Davide Liborio VetranoDepartment of Geriatrics, Catholic University of Rome, Rome, Italy.
Andrea CorsonelloUnit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging (INRCA), Cosenza, Italy.
Fabrizia LattanzioScientific Direction, Italian National Research Centre on Aging, Ancona, Italy.
Sergio Ladrón-AranaDepartment of Geriatrics, Complejo Hospitalario de Navarra, C/Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
Graziano OnderDepartment of Geriatrics, Catholic University of Rome, Rome, Italy.
Complejo Hospitalario de Navarra · ESUniversità Cattolica del Sacro Cuore · ITIstituto Nazionale di Riposo e Cura per Anziani · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study is to investigate whether there is an association between anticholinergic burden and mortality or rehospitalization in older adults discharged from hospital.

methodsProspective multicenter cohort study carried out with patients aged 65 and older discharged from seven acute care hospitals. The primary outcomes of the study were rehospitalization and mortality within 1 year after discharge. The study population was classified in three groups according to the anticholinergic exposure measured by the Anticholinergic Risk Scale (ARS) and Durán's list at the time of hospital discharge: without risk (ARS/Durán = 0), low risk (ARS/Durán = 1), and high risk (ARS/Durán ≥ 2). Predictors of hospitalizations and mortality were examined using regression models adjusting for important covariates.

resultsThe mean age of the 921 participants was 81.2 years (SD = 7.4 years). Prevalence of exposure to medications with anticholinergic activity ranged from 19.6% with ARS to 32.1% with Durán's list. During the follow-up period, 30.4% of participants were hospitalized and 19.4% died. Multivariate regression analysis showed that low anticholinergic burden quantified according to Durán's list was significantly associated with all-cause mortality (OR 1.69, 95% CI 1.02-2.82). This association was not present after adjustment when using ARS. No statistically significant association was found between anticholinergic burden and hospitalizations.

conclusionsTaking medications with anticholinergic activity is associated with greater risk of mortality in older adults discharged from acute care hospitals. Strategies to reduce anticholinergic burden in vulnerable elders could be useful to improve health outcomes. Further research is required to assess the association between anticholinergic burden and hospitalizations in older patients.

Indexed as

AgedAged, 80 and overCholinergic AntagonistsDrug UtilizationFemaleHospitalizationHospitalsHumansMaleMortalityCholinergic AntagonistsAdverse drug eventsAnticholinergic burdenElderlyHospitalizationMortality

Identifiers

PMID28766100
OpenAlexW2741630474

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.