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The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis

BACKGROUND: Anticholinergic acting drugs have been associated with delirium in older patients. OBJECTIVE: To examine the association between the anticholinergic burden (ACB) and the duration and severity of delirium in older hip‐surgery patients with or without haloperidol prophylaxis. METHODS: Olde...

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Autores principales: Tillemans, Monique P. H., Butterhoff‐Terlingen, Madelon H., Stuffken, Rutger, Vreeswijk, Ralph, Egberts, Toine C. G., Kalisvaart, Kees J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671783/
https://www.ncbi.nlm.nih.gov/pubmed/34758516
http://dx.doi.org/10.1002/brb3.2404
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author Tillemans, Monique P. H.
Butterhoff‐Terlingen, Madelon H.
Stuffken, Rutger
Vreeswijk, Ralph
Egberts, Toine C. G.
Kalisvaart, Kees J.
author_facet Tillemans, Monique P. H.
Butterhoff‐Terlingen, Madelon H.
Stuffken, Rutger
Vreeswijk, Ralph
Egberts, Toine C. G.
Kalisvaart, Kees J.
author_sort Tillemans, Monique P. H.
collection PubMed
description BACKGROUND: Anticholinergic acting drugs have been associated with delirium in older patients. OBJECTIVE: To examine the association between the anticholinergic burden (ACB) and the duration and severity of delirium in older hip‐surgery patients with or without haloperidol prophylaxis. METHODS: Older patients with a postoperative delirium following hip surgery from a randomized controlled trial investigating the effects of haloperidol prophylaxis on delirium incidence were included in this study. The ACB was quantified using two different tools, the Anticholinergic Drug Scale and an Expert Panel. Using linear regression, the association between the ACB and delirium was analyzed. RESULTS: Overall delirium duration and severity were not significantly associated with the ACB. Also, no statistically significant differences were found in delirium duration or severity between the placebo and haloperidol treatment groups for the ACB groups. The protective effect of haloperidol on delirium duration and severity however tended to be present in patients with no or a low ACB but not or to a lesser extent in patients with an intermediate to high ACB. CONCLUSIONS: The ACB was not significantly associated with delirium duration or severity. Haloperidol prophylaxis tended to shorten delirium duration and decrease delirium severity in patients with no or a low ACB. To further explore the influence of anticholinergic acting drugs on delirium duration and severity and the effect of concomitant haloperidol use, additional research with a higher haloperidol dose, a larger study population, and ACB quantification taking drug exposure into account is warranted.
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spelling pubmed-86717832021-12-21 The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis Tillemans, Monique P. H. Butterhoff‐Terlingen, Madelon H. Stuffken, Rutger Vreeswijk, Ralph Egberts, Toine C. G. Kalisvaart, Kees J. Brain Behav Original Articles BACKGROUND: Anticholinergic acting drugs have been associated with delirium in older patients. OBJECTIVE: To examine the association between the anticholinergic burden (ACB) and the duration and severity of delirium in older hip‐surgery patients with or without haloperidol prophylaxis. METHODS: Older patients with a postoperative delirium following hip surgery from a randomized controlled trial investigating the effects of haloperidol prophylaxis on delirium incidence were included in this study. The ACB was quantified using two different tools, the Anticholinergic Drug Scale and an Expert Panel. Using linear regression, the association between the ACB and delirium was analyzed. RESULTS: Overall delirium duration and severity were not significantly associated with the ACB. Also, no statistically significant differences were found in delirium duration or severity between the placebo and haloperidol treatment groups for the ACB groups. The protective effect of haloperidol on delirium duration and severity however tended to be present in patients with no or a low ACB but not or to a lesser extent in patients with an intermediate to high ACB. CONCLUSIONS: The ACB was not significantly associated with delirium duration or severity. Haloperidol prophylaxis tended to shorten delirium duration and decrease delirium severity in patients with no or a low ACB. To further explore the influence of anticholinergic acting drugs on delirium duration and severity and the effect of concomitant haloperidol use, additional research with a higher haloperidol dose, a larger study population, and ACB quantification taking drug exposure into account is warranted. John Wiley and Sons Inc. 2021-11-10 /pmc/articles/PMC8671783/ /pubmed/34758516 http://dx.doi.org/10.1002/brb3.2404 Text en © 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Tillemans, Monique P. H.
Butterhoff‐Terlingen, Madelon H.
Stuffken, Rutger
Vreeswijk, Ralph
Egberts, Toine C. G.
Kalisvaart, Kees J.
The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis
title The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis
title_full The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis
title_fullStr The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis
title_full_unstemmed The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis
title_short The effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: A post hoc analysis
title_sort effect of the anticholinergic burden on duration and severity of delirium in older hip‐surgery patients with and without haloperidol prophylaxis: a post hoc analysis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671783/
https://www.ncbi.nlm.nih.gov/pubmed/34758516
http://dx.doi.org/10.1002/brb3.2404
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