Assessment of aspiration pneumonia using the Anticholinergic Risk Scale

The association between anticholinergic drug use and aspiration pneumonia (AP) based on the Anticholinergic Risk Scale (ARS) or clinical study reports on AP risks using the ARS are unclear in Japan. The aim of the present study was to establish whether anticholinergic load affects AP, and to clarify the risk based on the ARS score among geriatric patients in the convalescing stage.

This retrospective longitudinal cohort study included consecutive geriatric patients admitted and discharged from convalescent rehabilitation wards between 2010 and 2016. Participants were divided based on the presence or absence of an increased anticholinergic load from admission to discharge. Demographic data, laboratory data and the Functional Independence Measure were analyzed between groups. The primary outcome was the presence of AP. Multiple logistic regression analysis was carried out to analyze the relationship between anticholinergic drug use and AP.

In total, 618 participants (220 men, 398 women; interquartile range 73-84 years) were included in the present study. Multiple logistic regression analysis of AP, adjusting for confounding factors, showed that anticholinergic drug use was independently and positively correlated with AP. In particular, an increase in ARS score by 2 points correlates with a 1.92-fold greater risk for AP, and an increase of ≥3 points results in a 3.25-fold greater risk, both being statistically significant results.

Increased anticholinergic load during hospitalization might be a predictor of increased AP in geriatric patients. Geriatr Gerontol Int 2018; 18: 1230-1235.