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Effects of Potent Anticholinergics, Sedatives and Antipsychotics on Postoperative Mortality in Elderly Patients with Hip Fracture

A Retrospective, Population-Based Study

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Abstract

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 ≥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. 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.

Conclusion: Use of potent anticholinergics should be evaluated critically after diseases.

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Acknowledgements

This study was supported by a Satakunta Hospital District EVO-grant. The financial sponsor had no role in the design and conduct of the study or in the preparation, review and approval of the manuscript.

The authors have no conflicts of interest that are directly relevant to the content of this study.

The authors wish to thank Virginia Mattila, University of Tampere, Finland, for editing the language and Jukka Saukkoriipi for technical assistance in biostatistics.

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Authors and Affiliations

  1. Department of Surgery, Pori City Hospital, Pori, Finland

    Jorma Panula

  2. Department of Neurology, Satakunta Central Hospital, Pori, Finland

    Juha Puustinen

  3. Rauma Health Office, Rauma, Finland

    Pekka Jaatinen

  4. Department of Biostatistics, University of Turku, Turku, Finland

    Tero Vahlberg

  5. Department of Surgery, University of Turku, Turku, Finland

    Pertti Aarnio

  6. Department of Surgery, Satakunta Central Hospital, Pori, Finland

    Pertti Aarnio

  7. Department of Family Medicine, University of Turku, Turku, Finland

    Sirkka-Liisa Kivela

  8. Unit of Family Medicine, Turku University Central Hospital and Satakunta Central Hospital, Pori, Finland

    Sirkka-Liisa Kivela

Authors
  1. Jorma Panula
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  2. Juha Puustinen
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  3. Pekka Jaatinen
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  4. Tero Vahlberg
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  5. Pertti Aarnio
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  6. Sirkka-Liisa Kivela
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Correspondence to Jorma Panula.

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Panula, J., Puustinen, J., Jaatinen, P. et al. Effects of Potent Anticholinergics, Sedatives and Antipsychotics on Postoperative Mortality in Elderly Patients with Hip Fracture. Drugs Aging 26, 963–971 (2009). https://doi.org/10.2165/11317660-000000000-00000

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  • DOI: https://doi.org/10.2165/11317660-000000000-00000

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