抗胆碱能药物对老年患者跌倒谵妄和住院时间的影响

Effects of anticholinergic drugs on falls,delirium and length of hospital stay in elderly patients

目的 探讨老年住院患者抗胆碱能药物的使用及其对跌倒、谵妄和住院时间(LOS)的影响.方法 收集2018年1月至2019年1月于本院老年内科病房的老年患者(>60岁)数据,根据患者是否使用抗胆碱能药物分为抗胆碱能药物组和对照组,分析评估抗胆碱能药物对跌倒、谵妄和LOS的影响.结果 共纳入老年患者145例,平均年龄(72±8)岁,其中女性占51.7%,平均住院天数为(6.0±2.1)d,其中抗胆碱能药物组90例,占62.1%.常用的抗胆碱能药物是呋塞米(59例),其次为雷尼替丁(44例)、华法林(23例)和甲泼尼龙(22例).与对照组相比,抗胆碱能药物组患者跌倒[比值比(OR)=2.61;P=0.018]、谵妄(OR=3.60;P=0.003)和LOS(OR=4.83;P<0.01)风险显著增加.结论 抗胆碱能药物增加老年患者跌倒、谵妄和LOS延长的风险.

Objective To investigate the effects of anticholinergic drugs on falls,delirium and length of hospital stay(LOS)in elderly inpatients.Methods Data of aged patients(over 60 years old)in the geriatric internal medicine ward of our hospital from January 2018 to January 2019 were collected.Patients were divided into anti-cholinergic drugs group and control group according to whether or not anticholinergic drugswas used.Chi-square test and multivariate logistic regression analysis were performed to evaluate the effects of anticholinergic drugs on falls,delirium and LOS.Results A total of 145 elderly patients were included in the study,with an average age of(72±8)years,51.7%of whom were female,the average length of hospital stay was(6.0±2.1)days,and 90(62.1%)were given anticholinergic drugs.The incidence of anticholinergic drugs was 62.1%(n=90).The most commonly prescribed anticholinergic drugs are furosemide(n=59),followed by ranitidine(n=44),warfarin(n=23),and methylprednisolone(n=22).Patients in the anticholinergic group had a significantly increased risk of falls[odds ratio(OR)=2.61;P=0.018],delirium(OR=3.60;P=0.003),and LOS(OR=4.83;P<0.01)compared with the control group.Conclusions Anticholinergic drugs increase the risk of falls,delirium,and prolonged LOS in elderly patients.