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[Analysis of iatrogenic risk related to anticholinergic effects using two scales in acute geriatric inpatient unit].
Geriatr Psychol Neuropsychiatr Vieil. 2012 Mar; 10(1):27-32.GP

Abstract

Anticholinergic medications are responsible for most frequent adverse drug effects. Two scales have been elaborated as tools for prescribers: the Anticholinergic Drug Scale (ADS) of Carnahan et al., and the Anticholinergic Risk Scale (ARS) of Rudolph et al. The objective of this study was to analyze the diagnostic performance of both scales for predicting signs related to an anticholinergic effect.

METHOD

Medical records of 1379 patients aged 75 years or older hospitalized in a geriatric acute care unit between 2002 and 2005 were studied. The analyze was made retrospectively, but data were collected prospectively.

RESULTS

Risk of appearance of total anticholinergic signs (ADS : OR 1,45, CI 95% [1,03-2,03], p=0,037 and ARS : OR 1,98, CI 95% [1,19-3,28] p<0,01) and peripheral signs (ADS: OR 1,66, CI 95% [1,22-2,26], p<0,01 and ARS : OR 1,81, CI 95% [1,19-2,75], p<0,01) increased when score was ≥ 3 with both scales, which wasn't the case for central signs.

CONCLUSION

Both scales permitted to detect an increased risk of appearance of total and peripheral anticholinergic signs, but not the centrals as delirium. Interest of total anticholinergic burden remains to be demonstrated, especially for delirium risk assessment.

Authors+Show Affiliations

Pôle de gérontologie clinique, CHU de Nantes. aude.gouraud@chu-nantes.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

22414395

Citation

Gouraud-Tanguy, Aude, et al. "[Analysis of Iatrogenic Risk Related to Anticholinergic Effects Using Two Scales in Acute Geriatric Inpatient Unit]." Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement, vol. 10, no. 1, 2012, pp. 27-32.
Gouraud-Tanguy A, Berlioz-Thibal M, Brisseau JM, et al. [Analysis of iatrogenic risk related to anticholinergic effects using two scales in acute geriatric inpatient unit]. Geriatr Psychol Neuropsychiatr Vieil. 2012;10(1):27-32.
Gouraud-Tanguy, A., Berlioz-Thibal, M., Brisseau, J. M., Ould Aoudia, V., Beauchet, O., Berrut, G., & De Decker, L. (2012). [Analysis of iatrogenic risk related to anticholinergic effects using two scales in acute geriatric inpatient unit]. Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement, 10(1), 27-32. https://doi.org/10.1684/pnv.2012.0337
Gouraud-Tanguy A, et al. [Analysis of Iatrogenic Risk Related to Anticholinergic Effects Using Two Scales in Acute Geriatric Inpatient Unit]. Geriatr Psychol Neuropsychiatr Vieil. 2012;10(1):27-32. PubMed PMID: 22414395.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Analysis of iatrogenic risk related to anticholinergic effects using two scales in acute geriatric inpatient unit]. AU - Gouraud-Tanguy,Aude, AU - Berlioz-Thibal,Marielle, AU - Brisseau,Jean-Marie, AU - Ould Aoudia,Vincent, AU - Beauchet,Olivier, AU - Berrut,Gilles, AU - De Decker,Laure, PY - 2012/3/15/entrez PY - 2012/3/15/pubmed PY - 2012/5/23/medline SP - 27 EP - 32 JF - Geriatrie et psychologie neuropsychiatrie du vieillissement JO - Geriatr Psychol Neuropsychiatr Vieil VL - 10 IS - 1 N2 - UNLABELLED: Anticholinergic medications are responsible for most frequent adverse drug effects. Two scales have been elaborated as tools for prescribers: the Anticholinergic Drug Scale (ADS) of Carnahan et al., and the Anticholinergic Risk Scale (ARS) of Rudolph et al. The objective of this study was to analyze the diagnostic performance of both scales for predicting signs related to an anticholinergic effect. METHOD: Medical records of 1379 patients aged 75 years or older hospitalized in a geriatric acute care unit between 2002 and 2005 were studied. The analyze was made retrospectively, but data were collected prospectively. RESULTS: Risk of appearance of total anticholinergic signs (ADS : OR 1,45, CI 95% [1,03-2,03], p=0,037 and ARS : OR 1,98, CI 95% [1,19-3,28] p<0,01) and peripheral signs (ADS: OR 1,66, CI 95% [1,22-2,26], p<0,01 and ARS : OR 1,81, CI 95% [1,19-2,75], p<0,01) increased when score was ≥ 3 with both scales, which wasn't the case for central signs. CONCLUSION: Both scales permitted to detect an increased risk of appearance of total and peripheral anticholinergic signs, but not the centrals as delirium. Interest of total anticholinergic burden remains to be demonstrated, especially for delirium risk assessment. SN - 2115-8789 UR - https://www.unboundmedicine.com/medline/citation/22414395/[Analysis_of_iatrogenic_risk_related_to_anticholinergic_effects_using_two_scales_in_acute_geriatric_inpatient_unit]_ DB - PRIME DP - Unbound Medicine ER -