The Prevalence of Anticholinergic Drugs and Correlation with Pneumonia in Elderly Patients: A Population-Based Study in Taiwan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Study Subjects
2.3. Study Design
2.4. Statistical Analysis
3. Results
3.1. The Prevalence of Anticholinergic Drugs
3.2. The Baseline Characteristics Distribution of Study Subjects
3.3. The Incidence Rate of Pneumonia in Elderly Patients
3.4. Correlation between Anticholinergic Drugs and Pneumonia
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Anticholinergic Drugs |
---|
Amitriptyline hydrochloride |
Atropine products |
Benztropine mesylate |
Carisoprodol |
Chlorpheniramine maleate |
Chlorpromazine hydrochloride |
Cyproheptadine hydrochloride |
Dicyclomine hydrochloride |
Diphenhydramine hydrochloride |
Fluphenazine hydrochloride |
Hydroxyzine hydrochloride and hydroxyzine pamoate |
Hyoscyamine products |
Imipramine hydrochloride |
Meclizine hydrochloride |
Oxybutynin chloride |
Perphenazine |
Promethazine hydrochloride |
Thioridazine hydrochloride |
Thiothixene |
Tizanidine hydrochloride |
Trifluoperazine hydrochloride |
Amantadine hydrochloride |
Baclofen |
Cetirizine hydrochloride |
Cimetidine |
Clozapine |
Cyclobenzaprine hydrochloride |
Desipramine hydrochloride |
Loperamide hydrochloride |
Loratadine |
Nortriptyline hydrochloride |
Olanzapine |
Prochlorperazine maleate |
Pseudoephedrine hydrochloride-triprolidine hydrochloride |
Tolterodine tartrate |
Carbidopa-levodopa |
Entacapone |
Haloperidol |
Metocarbamol |
Metoclopramide hydrochloride |
Mirtazapine |
Paroxetine hydrochloride |
Pramipexole dihydrochloride |
Quetiapine fumarate |
Ranitidine hydrochloride |
Risperidone |
Selegiline hydrochloride |
Trazodone hydrochloride |
Ziprasidone hydrochloride |
References
- Soukup, O.; Winder, M.; Killi, U.K.; Wsol, V.; Jun, D.; Ramalho, T.D.C.; Tobin, G. Acetylcholinesterase Inhibitors and Drugs Acting on Muscarinic Receptors-Potential Crosstalk of Cholinergic Mechanisms during Pharmacological Treatment. Curr. Neuropharmacol. 2017, 15, 637–653. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Feinberg, M. The Problems of Anticholinergic Adverse Effects in Older Patients. Drugs Aging 1993, 3, 335–348. [Google Scholar] [CrossRef]
- Tune, L.E. Anticholinergic effects of medication in elderly patients. J. Clin. Psychiatry 2001, 62, 11–14. [Google Scholar] [PubMed]
- Gutiérrez, F.; Masiá, M. Improving Outcomes of Elderly Patients with Community-Acquired Pneumonia. Drugs Aging 2008, 25, 585–610. [Google Scholar] [CrossRef] [PubMed]
- Stupka, J.E.; Mortensen, E.M.; Anzueto, A.; Restrepo, M.I. Community-acquired pneumonia in elderly patients. Aging Health 2009, 5, 763–774. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chatterjee, S.; Carnahan, R.M.; Chen, H.; Holmes, H.M.; Johnson, M.L.; Aparasu, R.R. Anticholinergic Medication Use and Risk of Pneumonia in Elderly Adults: A Nested Case-Control Study. J. Am. Geriatr. Soc. 2016, 64, 394–400. [Google Scholar] [CrossRef]
- Venkatesan, P.; Gladman, J.R.F.; Macfarlane, J.T.; Barer, D.; Berman, P.; Kinnear, W.; Finch, R.G. A hospital study of community acquired pneumonia in the elderly. Thorax 1990, 45, 254–258. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Riquelme, R.; Torres, A.; El-Ebiary, M.; De La Bellacasa, J.P.; Estruch, R.; Mensa, J.; Fernández-Solà, J.; Hernández, C.; Rodriguez-Roisin, R. Community-acquired pneumonia in the elderly: A multivariate analysis of risk and prognostic factors. Am. J. Respir. Crit. Care Med. 1996, 154, 1450–1455. [Google Scholar] [CrossRef]
- Huxley, E.J.; Viroslav, J.; Gray, W.R.; Pierce, A.K. Pharyngeal aspiration in normal adults and patients with depressed consciousness. Am. J. Med. 1978, 64, 564–568. [Google Scholar] [CrossRef]
- Paul, K.J.; Walker, R.L.; Dublin, S. Anticholinergic Medications and Risk of Community-Acquired Pneumonia in Elderly Adults: A Population-Based Case-Control Study. J. Am. Geriatr. Soc. 2015, 63, 476–485. [Google Scholar] [CrossRef]
- Marik, P.E.; Kaplan, D. Aspiration Pneumonia and Dysphagia in the Elderly. Chest 2003, 124, 328–336. [Google Scholar] [CrossRef]
- Fick, D.M.; Cooper, J.W.; Wade, W.E.; Waller, J.L.; MacLean, J.R.; Beers, M.H. Updating the Beers criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. Arch. Intern. Med. 2003, 163, 2716–2724. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shrank, W.; Polinski, J.M.; Avorn, J. Quality Indicators for Medication Use in Vulnerable Elders. J. Am. Geriatr. Soc. 2007, 55, S373–S382. [Google Scholar] [CrossRef] [PubMed]
- Gorup, E.; Rifel, J.; Šter, M.P. Anticholinergic burden and most common anticholinergic-acting medicines in older general practice patients. Slov. J. Public Health 2018, 57, 140–147. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Salahudeen, M.; Duffull, S.B.; Nishtala, P. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: A systematic review. BMC Geriatr. 2015, 15, 31. [Google Scholar] [CrossRef] [Green Version]
- Sittironnarit, G.; Ames, D.; Bush, A.I.; Faux, N.G.; Flicker, L.; Foster, J.; Hilmer, S.N.; Lautenschlager, N.T.; Maruff, P.; Masters, C.L.; et al. Effects of Anticholinergic Drugs on Cognitive Function in Older Australians: Results from the AIBL Study. Dement. Geriatr. Cogn. Disord. 2011, 31, 173–178. [Google Scholar] [CrossRef]
- Rudolph, J.L.; Salow, M.J.; Angelini, M.C.; McGlinchey, R.E. The Anticholinergic Risk Scale and Anticholinergic Adverse Effects in Older Persons. Arch. Intern. Med. 2008, 168, 508. [Google Scholar] [CrossRef] [Green Version]
- Lampela, P.; Tolppanen, A.; Tanskanen, A.; Tiihonen, J.; Hartikainen, S.; Taipale, H. Anticholinergic Exposure and Risk of Pneumonia in Persons with Alzheimer’s Disease: A Nested Case-Control Study. J. Alzheimer Dis. 2017, 56, 119–128. [Google Scholar] [CrossRef]
- Miyashita, N.; Yamauchi, Y. Bacterial Pneumonia in Elderly Japanese Populations. Jpn. Clin. Med. 2018, 9, 1179670717751433. [Google Scholar] [CrossRef] [Green Version]
- Lee, T.-Y.; Hsu, Y.-C.; Tseng, H.-C.; Yu, S.-H.; Lin, J.-T.; Wu, M.-S.; Wu, C.-Y. Association of Daily Aspirin Therapy With Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B. JAMA Intern. Med. 2019, 179, 633–640. [Google Scholar] [CrossRef]
- Cheng, Y.-T.; Cheng, C.-T.; Wang, S.-Y.; Wu, V.C.-C.; Chu, P.-H.; Chou, A.-H.; Chen, C.-C.; Ko, P.-J.; Liu, K.-S.; Chen, S.-W. Long-term Outcomes of Endovascular and Open Repair for Traumatic Thoracic Aortic Injury. JAMA Netw. Open 2019, 2, e187861. [Google Scholar] [CrossRef] [Green Version]
- Wang, C.J.; Cheng, S.H.; Wu, J.-Y.; Lin, Y.-P.; Kao, W.-H.; Lin, C.-L.; Chen, Y.-J.; Tsai, S.-L.; Kao, F.-Y.; Huang, A.T. Association of a Bundled-Payment Program With Cost and Outcomes in Full-Cycle Breast Cancer Care. JAMA Oncol. 2017, 3, 327–334. [Google Scholar] [CrossRef] [PubMed]
- Wei, K.-C.; Bee, Y.-S.; Wang, W.-H.; Huang, Y.-T.; Lu, T.-H. Incidence of Cataract Surgery in Patients After Percutaneous Cardiac Intervention in Taiwan. JAMA Intern. Med. 2016, 176, 710. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Woodhead, M. Inhaled corticosteroids cause pneumonia or do they? Am. J. Respir. Crit. Care Med. 2007, 176, 111–112. [Google Scholar] [CrossRef]
- Farr, B.; Woodhead, M.; Macfarlane, J.; Bartlett, C.; McCracken, J.; Wadsworth, J.; Miller, D. Risk factors for community-acquired pneumonia diagnosed by general practitioners in the community. Respir. Med. 2000, 94, 422–427. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Almirall, J.; Bolíbar, I.; Serra-Prat, M.; Roig, J.; Hospital, I.; Carandell, E.; Agustí, M.; Ayuso, P.; Estela, A.; Torres, A.; et al. New evidence of risk factors for community-acquired pneumonia: A population-based study. Eur. Respir. J. 2008, 31, 1274–1284. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jackson, M.L.; Neuzil, K.M.; Thompson, W.W.; Shay, D.; Yu, O.; Hanson, C.A.; Jackson, L.A. The Burden of Community-Acquired Pneumonia in Seniors: Results of a Population-Based Study. Clin. Infect. Dis. 2004, 39, 1642–1650. [Google Scholar] [CrossRef] [Green Version]
- Bouter, K.; Diepersloot, R.J.; Van Romunde, L.K.; Uitslager, R.; Masurel, N.; Hoekstra, J.B.; Erkelens, D.W. Effect of epidemic influenza on ketoacidosis, pneumonia and death in diabetes mellitus: A hospital register survey of 1976–1979 in The Netherlands. Diabetes Res. Clin. Pract. 1991, 12, 61–68. [Google Scholar] [CrossRef]
- Martin, J.-J.; Boavida, J.M.; Raposo, J.F.; Froes, F.; Nunes, B.; Ribeiro, R.T.; Macedo, M.; Penha-Gonçalves, C. Diabetes hinders community-acquired pneumonia outcomes in hospitalized patients. BMJ Open Diabetes Res. Care 2016, 4, e000181. [Google Scholar] [CrossRef] [Green Version]
- Kalf, J.; De Swart, B.; Bloem, B.R.; Munneke, M. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: A meta-analysis. Park. Relat. Disord. 2012, 18, 311–315. [Google Scholar] [CrossRef]
- Loeb, M.; Neupane, B.; Walter, S.D.; Hanning, R.; Carusone, S.C.; Lewis, D.; Krueger, P.; Simor, A.E.; Nicolle, L.; Marrie, T.J. Environmental Risk Factors for Community-Acquired Pneumonia Hospitalization in Older Adults. J. Am. Geriatr. Soc. 2009, 57, 1036–1040. [Google Scholar] [CrossRef] [PubMed]
- Almirall, J.; Rofes, L.; Serra-Prat, M.; Icart, R.; Palomera, E.; Arreola, V.; Clavé, P. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur. Respir. J. 2012, 41, 923–928. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chang, Y.-P.; Yang, C.-J.; Hu, K.-F.; Chao, A.-C.; Chang, Y.-H.; Hsieh, K.-P.; Tsai, J.-H.; Ho, P.-S.; Lim, S.-Y. Risk factors for pneumonia among patients with Parkinson’s disease: A Taiwan nationwide population-based study. Neuropsychiatr. Dis. Treat. 2016, 12, 1037–1046. [Google Scholar] [CrossRef] [Green Version]
- McDonald, H.; Thomas, S.L.; Nitsch, R. Chronic kidney disease as a risk factor for acute community-acquired infections in high-income countries: A systematic review. BMJ Open 2014, 4, e004100. [Google Scholar] [CrossRef]
- Bornheimer, R.; Shea, K.M.; Sato, R.; Weycker, D.; Pelton, S.I. Risk of exacerbation following pneumonia in adults with heart failure or chronic obstructive pulmonary disease. PLoS ONE 2017, 12, e0184877. [Google Scholar] [CrossRef] [Green Version]
- Hsu, W.-T.; Lai, C.-C.; Wang, Y.-H.; Tseng, P.-H.; Wang, K.; Wang, C.-Y.; Chen, L. Risk of pneumonia in patients with gastroesophageal reflux disease: A population-based cohort study. PLoS ONE 2017, 12, e0183808. [Google Scholar] [CrossRef]
- Laheij, R.J.; Sturkenboom, M.C.J.M.; Hassing, R.-J.; Dieleman, J.; Stricker, B.H.C.; Jansen, J.B.M.J. Risk of Community-Acquired Pneumonia and Use of Gastric Acid–Suppressive Drugs. JAMA 2004, 292, 1955–1960. [Google Scholar] [CrossRef]
Prescriptions | No. of Prescriptions | No. of Patients Had Received | ||
---|---|---|---|---|
N | % | N | % | |
Total | 7,467,908 | 100.00 | 275,005 | 100.00 |
Without anticholinergic drugs | 6,500,021 | 87.04 | 109,743 | 39.91 |
With anticholinergic drugs | 967,887 | 12.96 | 165,262 | 60.09 |
Most frequency anticholinergic drugs | ||||
Cimetidine | 189,862 | 2.54 | 53,171 | 19.33 |
Cetirizine | 88,587 | 1.19 | 33,987 | 12.36 |
Pseudoephedrine | 86,201 | 1.15 | 36,453 | 13.26 |
Metoclopramide | 84,483 | 1.13 | 30,241 | 11.00 |
Ranitidine | 61,831 | 0.83 | 16,066 | 5.84 |
Quetiapine | 59,961 | 0.80 | 8126 | 2.95 |
Carbidopa–Levodopa | 49,145 | 0.66 | 6371 | 2.32 |
Loratadine | 48,793 | 0.65 | 20,132 | 7.32 |
Trazodone | 40,079 | 0.54 | 6875 | 2.50 |
Loperamide | 38,237 | 0.51 | 20,527 | 7.46 |
Variables | Crude Data | After Matching | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Anticholinergic Drugs | SMD 3 | p-Value 1 | Anticholinergic Drugs | SMD 3 | p-Value 1 | |||||||
Without | With | Without | With | |||||||||
N | % | N | % | N | % | N | % | |||||
Total | 55,345 | 100.00 | 32,230 | 100.00 | 32,215 | 100.00 | 32,215 | 100.00 | ||||
Gender 2 | 0.08 | <0.001 | 0 | 0.969 | ||||||||
Female | 27,610 | 49.89 | 17,337 | 53.79 | 17,317 | 53.75 | 17,322 | 53.77 | ||||
Male | 27,735 | 50.11 | 14,893 | 46.21 | 14,898 | 46.25 | 14,893 | 46.23 | ||||
Age (year) 2 | 73.28±7.42 | 73.58±7.35 | 0.05 | <0.001 | 73.59±7.42 | 73.58±7.35 | 0 | 0.981 | ||||
65–70 | 25,432 | 45.95 | 14,034 | 43.54 | 13,992 | 43.43 | 14,034 | 43.56 | ||||
71–75 | 11,619 | 20.99 | 6881 | 21.35 | 6878 | 21.35 | 6878 | 21.35 | ||||
76–80 | 8317 | 15.03 | 5322 | 16.51 | 5344 | 16.59 | 5310 | 16.48 | ||||
>80 | 9977 | 18.03 | 5993 | 18.59 | 6001 | 18.63 | 5993 | 18.60 | ||||
Insured salary 3 | 0.06 | <0.001 | 0 | 0.994 | ||||||||
<20,008 | 18,342 | 33.14 | 9070 | 28.14 | 9046 | 28.08 | 9070 | 28.15 | ||||
20,008–22,800 | 19,850 | 35.87 | 13,174 | 40.87 | 13,184 | 40.93 | 13,159 | 40.85 | ||||
22,801–50,600 | 11,176 | 20.19 | 6632 | 20.58 | 6621 | 20.55 | 6632 | 20.59 | ||||
>50,600 | 5977 | 10.80 | 3354 | 10.41 | 3364 | 10.44 | 3354 | 10.41 | ||||
Urbanization 2 | 0.07 | <0.001 | 0 | 0.903 | ||||||||
Urban | 42,143 | 76.15 | 23,434 | 72.71 | 23,480 | 72.89 | 23,434 | 72.74 | ||||
Suburban | 8781 | 15.87 | 5759 | 17.87 | 5729 | 17.78 | 5747 | 17.84 | ||||
Rural | 4421 | 7.99 | 3037 | 9.42 | 3006 | 9.33 | 3034 | 9.42 | ||||
CCI 2, 3 | 0.22 | <0.001 | 0 | 0.989 | ||||||||
0 | 32,820 | 59.30 | 15,617 | 48.45 | 15,626 | 48.51 | 15,617 | 48.48 | ||||
1–2 | 18,210 | 32.90 | 13,155 | 40.82 | 13,138 | 40.78 | 13,155 | 40.84 | ||||
≥3 | 4315 | 7.80 | 3458 | 10.73 | 3451 | 10.71 | 3443 | 10.69 | ||||
DM 3 | −0.14 | <0.001 | −0.02 | 0.015 | ||||||||
No | 43,788 | 79.12 | 23,605 | 73.24 | 23,872 | 74.10 | 23,601 | 73.26 | ||||
Yes | 11,557 | 20.88 | 8625 | 26.76 | 8343 | 25.90 | 8614 | 26.74 | ||||
AD 3 | −0.04 | <0.001 | −0.03 | <0.001 | ||||||||
No | 55,148 | 99.64 | 32,012 | 99.32 | 32,076 | 99.57 | 31,997 | 99.32 | ||||
Yes | 197 | 0.36 | 218 | 0.68 | 139 | 0.43 | 218 | 0.68 | ||||
Stroke | −0.11 | <0.001 | −0.04 | <0.001 | ||||||||
No | 51,081 | 92.30 | 28,768 | 89.26 | 29,131 | 90.43 | 28,758 | 89.27 | ||||
Yes | 4264 | 7.70 | 3462 | 10.74 | 3084 | 9.57 | 3457 | 10.73 | ||||
PD 3 | −0.08 | <0.001 | −0.08 | <0.001 | ||||||||
No | 55,175 | 99.69 | 31,913 | 99.02 | 32,101 | 99.65 | 31,898 | 99.02 | ||||
Yes | 170 | 0.31 | 317 | 0.98 | 114 | 0.35 | 317 | 0.98 | ||||
MDD 3 | −0.06 | <0.001 | −0.05 | <0.001 | ||||||||
No | 54,660 | 98.76 | 31,579 | 97.98 | 31,773 | 98.63 | 31,564 | 97.98 | ||||
Yes | 685 | 1.24 | 651 | 2.02 | 442 | 1.37 | 651 | 2.02 | ||||
CKD 3 | −0.13 | <0.001 | −0.08 | <0.001 | ||||||||
No | 51,169 | 92.45 | 28,540 | 88.55 | 29,312 | 90.99 | 28,532 | 88.57 | ||||
Yes | 4176 | 7.55 | 3690 | 11.45 | 2903 | 9.01 | 3683 | 11.43 | ||||
Asthma | −0.14 | <0.001 | −0.11 | <0.001 | ||||||||
No | 53,685 | 97.00 | 30,302 | 94.02 | 31,048 | 96.38 | 30,287 | 94.02 | ||||
Yes | 1660 | 3.00 | 1928 | 5.98 | 1167 | 3.62 | 1928 | 5.98 | ||||
COPD 3 | −0.19 | <0.001 | −0.15 | <0.001 | ||||||||
No | 53,077 | 95.90 | 29,448 | 91.37 | 30,653 | 95.15 | 29,434 | 91.37 | ||||
Yes | 2268 | 4.10 | 2782 | 8.63 | 1562 | 4.85 | 2781 | 8.63 | ||||
HF 3 | −0.08 | <0.001 | −0.05 | <0.001 | ||||||||
No | 54,226 | 97.98 | 31,150 | 96.65 | 31,429 | 97.56 | 31,139 | 96.66 | ||||
Yes | 1119 | 2.02 | 1080 | 3.35 | 786 | 2.44 | 1076 | 3.34 | ||||
URI 3 | −0.63 | <0.001 | −0.59 | <0.001 | ||||||||
No | 39,636 | 71.62 | 13,536 | 42.00 | 22,565 | 70.05 | 13,527 | 41.99 | ||||
Yes | 15,709 | 28.38 | 18,694 | 58.00 | 9650 | 29.95 | 18,688 | 58.01 | ||||
GERD 3 | −0.12 | <0.001 | −0.11 | <0.001 | ||||||||
No | 54,765 | 98.95 | 31,368 | 97.33 | 31,849 | 98.86 | 31,353 | 97.32 | ||||
Yes | 580 | 1.05 | 862 | 2.67 | 366 | 1.14 | 862 | 2.68 | ||||
Epilepsy | −0.02 | 0.004 | −0.01 | 0.075 | ||||||||
No | 55,199 | 99.74 | 32,109 | 99.62 | 32,121 | 99.71 | 32,095 | 99.63 | ||||
Yes | 146 | 0.26 | 121 | 0.38 | 94 | 0.29 | 120 | 0.37 |
Variables | Pneumonia | Risk Ratio | |
---|---|---|---|
N | Incident Rate (‰) | ||
Total | 1519 | 23.58 | |
Anticholinergic drugs | |||
Without | 529 | 15.27 | |
With | 990 | 33.23 | 2.18 |
Diabetes mellitus | |||
No | 1036 | 21.82 | |
Yes | 483 | 28.48 | 1.31 |
Alzheimer’s disease | |||
No | 1507 | 23.52 | |
Yes | 12 | 33.61 | 1.43 |
Stroke | |||
No | 1215 | 20.99 | |
Yes | 304 | 46.48 | 2.21 |
Parkinson’s disease | |||
No | 1490 | 23.28 | |
Yes | 29 | 67.29 | 2.89 |
Major depression disorder | |||
No | 1493 | 23.57 | |
Yes | 26 | 23.79 | 1.01 |
Chronic kidney disease | |||
No | 1255 | 21.70 | |
Yes | 264 | 40.09 | 1.85 |
Asthma | |||
No | 1187 | 19.35 | |
Yes | 332 | 107.27 | 5.54 |
Chronic obstructive pulmonary disease | |||
No | 1020 | 16.98 | |
Yes | 499 | 114.90 | 6.77 |
Heart failure | |||
No | 1404 | 22.44 | |
Yes | 115 | 61.76 | 2.75 |
Upper respiratory infection | |||
No | 594 | 16.46 | |
Yes | 925 | 32.64 | 1.98 |
Gastroesophageal reflux disease | |||
No | 1458 | 23.07 | |
Yes | 61 | 49.67 | 2.15 |
Epilepsy | |||
No | 1496 | 23.30 | |
Yes | 23 | 107.48 | 4.61 |
Variables | aOR 1,2 | 95% Confidence Interval | p-Value | |
---|---|---|---|---|
Anticholinergic agent | 1.33 | 1.18–1.49 | <0.001 | |
DM 1 | 1.44 | 1.26–1.65 | <0.001 | |
AD 1 | 1.20 | 0.66–2.18 | 0.561 | |
Stroke | 2.02 | 1.75–2.33 | <0.001 | |
PD 1 | 1.94 | 1.28–2.94 | 0.002 | |
MDD 1 | 0.74 | 0.49–1.12 | 0.158 | |
CKD 1 | 1.57 | 1.35–1.82 | <0.001 | |
Asthma | 1.57 | 1.31–1.87 | <0.001 | |
COPD 1 | 4.93 | 4.21–5.78 | <0.001 | |
HF 1 | 1.64 | 1.32–2.04 | <0.001 | |
URI 1 | 1.79 | 1.60–2.00 | <0.001 | |
GERD 1 | 1.52 | 1.15–2.01 | 0.003 | |
Epilepsy | 3.11 | 1.92–5.03 | <0.001 |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Lee, C.-Y.; Cheng, Y.-D.; Cheng, W.-Y.; Tsai, T.-H.; Huang, K.-H. The Prevalence of Anticholinergic Drugs and Correlation with Pneumonia in Elderly Patients: A Population-Based Study in Taiwan. Int. J. Environ. Res. Public Health 2020, 17, 6260. https://doi.org/10.3390/ijerph17176260
Lee C-Y, Cheng Y-D, Cheng W-Y, Tsai T-H, Huang K-H. The Prevalence of Anticholinergic Drugs and Correlation with Pneumonia in Elderly Patients: A Population-Based Study in Taiwan. International Journal of Environmental Research and Public Health. 2020; 17(17):6260. https://doi.org/10.3390/ijerph17176260
Chicago/Turabian StyleLee, Chien-Ying, Yih-Dih Cheng, Wei-Yuan Cheng, Tung-Han Tsai, and Kuang-Hua Huang. 2020. "The Prevalence of Anticholinergic Drugs and Correlation with Pneumonia in Elderly Patients: A Population-Based Study in Taiwan" International Journal of Environmental Research and Public Health 17, no. 17: 6260. https://doi.org/10.3390/ijerph17176260