title: [Analysis of iatrogenic risk related to anticholinergic effects using two scales in acute geriatric inpatient unit].
abstract: Anticholinergic medications are responsible for most frequent adverse drug effects. Two scales have been elaborated as tools for prescribers: the Anticholinergic Drug Scale (ADS) of Carnahan et al., and the Anticholinergic Risk Scale (ARS) of Rudolph et al. The objective of this study was to analyze the diagnostic performance of both scales for predicting signs related to an anticholinergic effect.
  
  
  METHODS
  Medical records of 1379 patients aged 75 years or older hospitalized in a geriatric acute care unit between 2002 and 2005 were studied. The analyze was made retrospectively, but data were collected prospectively.
  
  
  RESULTS
  Risk of appearance of total anticholinergic signs (ADS : OR 1,45, CI 95% [1,03-2,03], p=0,037 and ARS : OR 1,98, CI 95% [1,19-3,28] p<0,01) and peripheral signs (ADS: OR 1,66, CI 95% [1,22-2,26], p<0,01 and ARS : OR 1,81, CI 95% [1,19-2,75], p<0,01) increased when score was ≥ 3 with both scales, which wasn't the case for central signs.
  
  
  CONCLUSIONS
  Both scales permitted to detect an increased risk of appearance of total and peripheral anticholinergic signs, but not the centrals as delirium. Interest of total anticholinergic burden remains to be demonstrated, especially for delirium risk assessment.
authors.affiliation: Pôle de gérontologie clinique, CHU de Nantes. aude.gouraud@chu-nantes.fr
authors.forename: Aude
authors.initials: A
authors.lastname: Gouraud-Tanguy
authors.forename: Marielle
authors.initials: M
authors.lastname: Berlioz-Thibal
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Brisseau
authors.forename: Vincent
authors.initials: V
authors.lastname: Ould Aoudia
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
authors.forename: Gilles
authors.initials: G
authors.lastname: Berrut
authors.forename: Laure
authors.initials: L
authors.lastname: De Decker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018680:Cholinergic Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D005602:France; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000706:statistics & numerical data
chemical_list: D018680:Cholinergic Antagonists