| Autor: |
Andrew D. Ablett, Aimee Browning, Vincent Quan, Hui S. Tay, Caroline McCormack, Ben Carter, Jonathan Hewitt, Phyo K. Myint |
| Jazyk: |
angličtina |
| Rok vydání: |
2019 |
| Předmět: |
|
| Zdroj: |
Asian Journal of Surgery, Vol 42, Iss 4, Pp 527-534 (2019) |
| Druh dokumentu: |
article |
| ISSN: |
1015-9584 |
| DOI: |
10.1016/j.asjsur.2018.10.005 |
| Popis: |
Summary: Background/objective: The impact of medications with anti-cholinergic properties on morbidity and mortality of unselected adult patients admitted to the emergency general surgical setting has not been investigated. Methods: All cases were identified prospectively from unselected adult patients admitted to the emergency general surgical ward between May to July 2016 in a UK centre with a catchment population circa 500,000. Prescribed medication lists were ascertained from case notes and electronic medical records. Anti-Cholinergic Burden (ACB) was calculated from medication lists. Patients were categorised into three groups based on ACB; none (ACB score of 0); moderate (up to ACB score of two); high (ACB score more than two). The effect of increasing ACB on selected outcomes of 30- and 90-day mortality, hospital readmission within 30-days of discharge and increased length of hospital stay were examined using multivariable logistic regression models. Results: The 452 patients had a mean age (SD) of 51.7 (±20.6) years, 273 (60.4%) patients had no ACB burden, 106 (23.5%) had a ACB burden of up to two; and 73 (16.2%) had an ACB burden of > 2. Multivariable analyses showed no association between high ACB burden and 90-day (fully adjusted odds ratio [OR] 0.56 (95%CI 0.12–2.85); P = 0.48) and 30-day mortality (fully adjusted OR = 0.75 (95%CI 0.05–11.04); P = 0.84). A significant association was observed between moderate ACB burden and 30-day hospital readmission (fully adjusted OR = 2.01 (95%CI 1.09–3.71); P = 0.03). Conclusions: Anti-cholinergic burden may be linked to hospital readmission in adults admitted to an emergency general surgical ward. Keywords: Anti-Cholinergic Burden, 30-Day mortality, 90-Day mortality, 30-Day readmission, Length of hospital stay, Change in destination, Emergency surgery |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
