BACKGROUND: Concomitant use of several medications for somatic and mental disorders is common in elderly people and increases the risk of falls, with hip fracture being the most serious consequence. OBJECTIVE: The objective of this study was to describe relationships between use of sedatives, antipsychotics or potent anticholinergics and postoperative mortality in patients with hip fractures. METHODS: A retrospective analysis was conducted on population-based data collected during a 2-year period from 1999 to 2000 on 461 hip fracture surgery patients aged > or = 65 years in Finland. Information on co-morbidities and intake of sedatives, antipsychotics and potent anticholinergics was obtained from the original patient records. Information on deaths was obtained from the official death statistics in Finland. RESULTS: In men, use of potent anticholinergics was associated with excess age-adjusted mortality at 30 days, 3 months, 6 months and 3 years, but not in women at any timepoint. CONCLUSION: Use of potent anticholinergic drugs emerged as an independent predictor of excess mortality in men at 3 months and 3 years. Presence of cardiovascular disease and chronic lung disease were independent risk factors for excess mortality at 6 months and 3 years in men. In addition, chronic lung disease independently predicted excess mortality at 30 days. Use of potent anticholinergics should be evaluated critically after hip fracture surgery, especially in men with cardiovascular or chronic lung diseases.
BACKGROUND: Concomitant use of several medications for somatic and mental disorders is common in elderly people and increases the risk of falls, with hip fracture being the most serious consequence. OBJECTIVE: The objective of this study was to describe relationships between use of sedatives, antipsychotics or potent anticholinergics and postoperative mortality in patients with hip fractures. METHODS: A retrospective analysis was conducted on population-based data collected during a 2-year period from 1999 to 2000 on 461 hip fracture surgery patients aged > or = 65 years in Finland. Information on co-morbidities and intake of sedatives, antipsychotics and potent anticholinergics was obtained from the original patient records. Information on deaths was obtained from the official death statistics in Finland. RESULTS: In men, use of potent anticholinergics was associated with excess age-adjusted mortality at 30 days, 3 months, 6 months and 3 years, but not in women at any timepoint. CONCLUSION: Use of potent anticholinergic drugs emerged as an independent predictor of excess mortality in men at 3 months and 3 years. Presence of cardiovascular disease and chronic lung disease were independent risk factors for excess mortality at 6 months and 3 years in men. In addition, chronic lung disease independently predicted excess mortality at 30 days. Use of potent anticholinergics should be evaluated critically after hip fracture surgery, especially in men with cardiovascular or chronic lung diseases.
Authors: Lois E Wehren; William G Hawkes; Denise L Orwig; J Richard Hebel; Sheryl I Zimmerman; Jay Magaziner Journal: J Bone Miner Res Date: 2003-12 Impact factor: 6.741
Authors: Dustin D French; Elizabeth Bass; Douglas D Bradham; Robert R Campbell; Laurence Z Rubenstein Journal: J Am Geriatr Soc Date: 2007-11-15 Impact factor: 5.562
Authors: Sirpa Hartikainen; Merja Ahto; Minna Löppönen; Hannu Puolijoki; Pekka Laippala; Ansa Ojanlatva; Sirkka-Liisa Kivelä; Raimo Isoaho Journal: Scand J Prim Health Care Date: 2003-09 Impact factor: 2.581
Authors: Juho Uusvaara; Kaisu H Pitkala; Hannu Kautiainen; Reijo S Tilvis; Timo E Strandberg Journal: Drugs Aging Date: 2011-02-01 Impact factor: 3.923
Authors: Satabdi Chatterjee; Vishal Bali; Ryan M Carnahan; Hua Chen; Michael L Johnson; Rajender R Aparasu Journal: Drugs Aging Date: 2017-09 Impact factor: 3.923
Authors: Lisa-Ann Fraser; Jonathan D Adachi; William D Leslie; David Goltzman; Robert Josse; Jerilynn Prior; Stephanie Kaiser; Nancy Kreiger; Christopher S Kovacs; Tassos P Anastassiades; Alexandra Papaioannou Journal: Ann Pharmacother Date: 2014-05-09 Impact factor: 3.154