Does anticholinergics drug burden relate to global neuro-disability outcome measures and length of hospital stay?
OBJECTIVE
To assess the relationship between disability, length of stay (LOS) and anticholinergic burden (ACB) with people following acquired brain or spinal cord injury.


METHODS
A retrospective case note review assessed total rehabilitation unit admission.


METHODS
Assessment of 52 consecutive patients with acquired brain/spinal injury and neuropathy in an in-patient neuro-rehabilitation unit of a UK university hospital. Data analysed included: Northwick Park Dependency Score (NPDS), Rehabilitation complexity Scale (RCS), Functional Independence Measure and Functional Assessment Measure FIM-FAM (UK version 2.2), LOS and ACB. Outcome was different in RCS, NPDS and FIM-FAM between admission and discharge.


RESULTS
A positive change was reported in ACB results in a positive change in NPDS, with no significant effect on FIM-FAM, either Motor or Cognitive, or on the RCS. Change in ACB correlated to the length of hospital stay (regression correlation = -6.64; SE = 3.89). There was a significant harmful impact of increase in ACB score during hospital stay, from low to high ACB on NPDS (OR = 9.65; 95% CI = 1.36-68.64) and FIM-FAM Total scores (OR = 0.03; 95% CI = 0.002-0.35).


CONCLUSIONS
There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort.
a East Kent University NHS Hospitals , Canterbury , UK .
M
M
Sakel
b Aston University , Birmingham , UK .
A
A
Boukouvalas
c University of Aberdeen , Aberdeen , UK .
R
R
Buono
d Imperial College , London , UK .
M
M
Moten
a East Kent University NHS Hospitals , Canterbury , UK .
F
F
Mirza
e Norfolk and Norwich University Hospital , Norwich , UK , and.
W-Y
WY
Chan
b Aston University , Birmingham , UK .
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I
Maidment
f University of East Anglia , Norwich , UK.
J
J
Cross
f University of East Anglia , Norwich , UK.
T O
TO
Smith
c University of Aberdeen , Aberdeen , UK .
P K
PK
Myint
f University of East Anglia , Norwich , UK.
C
C
Fox
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000503:physiopathology / Q000534:rehabilitation; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000494:pharmacology*; D006233:Persons with Disabilities; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000639:trends; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation
D018680:Cholinergic Antagonists
Anticholingeric; adverse event; function; length of stay; rehabilitation unit; spinal cord; traumatic brain injury