Ayaka Matsumoto, Yoshihiro Yoshimura, Fumihiko Nagano, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Aomi Kuzuhara, Kota Hori, Takenori Hamada, Kouki Yoneda, Kenichiro Maekawa
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引用次数: 0
摘要
背景抗胆碱能药物负担与老年人的不良事件有关。本研究探讨了接受康复治疗的脑卒中后患者在住院期间抗胆碱能药物负担增加与排尿独立性之间的关系。本观察性横断面研究纳入了 2020 年至 2022 年期间入住急性期后康复医院且不能独立排尿的脑卒中患者。排尿独立性的程度使用功能独立性量表(FIM-Bladder)进行评估,FIM-Bladder是FIM运动领域的一个分量表,排尿独立性定义为FIM-Bladder≥6。使用抗胆碱能风险量表(ARS)评估抗胆碱能负担,用入院时的值减去出院时的值来计算住院期间ARS的变化。研究结果为出院时的排尿独立性。研究人员使用逻辑回归分析来检验 ARS 评分的变化是否与研究结果独立相关。统计显著性以 P < 0.05 为标准。有 57 名患者(18.3%)在住院期间 ARS 增加。ARS评分的变化与排尿独立性独立相关(几率比:0.432,95% 置信区间:0.247-0.756,P = 0.003)。需要协助排尿的患者可能需要谨慎使用抗胆碱能药物。
Exploring the impact of anticholinergic burden on urinary independence: insights from a post-stroke cohort of older adults
Background
Anticholinergic burden is associated with adverse events in the older adults. However, there is a lack of evidence regarding its effect on urinary independence in stroke patients.
Aim
This study examined the association between increased anticholinergic burden during hospitalization and urinary independence in post-stroke patients undergoing rehabilitation.
Method
This observational cross-sectional study included stroke patients admitted to a post-acute rehabilitation hospital between 2020 and 2022 who were not independently urinating. The degree of urinary independence was assessed using the Functional Independence Measure-Bladder (FIM-Bladder), a subscale of the motor domain of the FIM, and urinary independence was defined as FIM-Bladder ≥ 6. Anticholinergic burden was assessed using the anticholinergic risk scale (ARS), and changes in ARS during hospitalization were calculated by subtracting the value at admission from the value at discharge. The study outcome was urinary independence at discharge. Logistic regression analysis was used to examine whether change in ARS score was independently associated with the outcome. Statistical significance was set at P < 0.05.
Results
Of the 573 patients enrolled, 312 patients (mean age 77.5 years, 51.9% male) were included in the analysis. ARS increased during hospitalization in 57 patients (18.3%). Change in ARS score was independently associated with urinary independence (odds ratio: 0.432, 95% confidence interval: 0.247–0.756, P = 0.003).
Conclusion
Increased anticholinergic burden in post-stroke patients who require assistance with urination is significantly associated with less independent urination. Anticholinergic agents may need to be introduced cautiously in patients who require assistance with urination.
期刊介绍:
The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences.
IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy.
IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor.
International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy .
Until 2010 the journal was called Pharmacy World & Science.