Does anticholinergics drug burden relate to global neuro-disability outcome measures and length of hospital stay?

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Sakel, Mohamed ; Boukouvalas, Alexis ; Buono, Romain ; Moten, Maliha ; Mirza, Farhat ; Chan, Wei Yee ; Maidment, Ian D ; Cross, Jane ; Smith, Toby ; Myint, Phyo ; Fox, Chris (2015)

Primary Objective: To assess the relationship between disability, length of stay (LOS) and anticholinergic burden (ACB) with people following acquired brain or spinal cord injury. Research Design: A retrospective case note review assessed total rehabilitation unit admission. Methods & Procedures: Assessment of 52 consecutive patients with acquired brain/spinal injury and neuropathy in an in-patient neuro-rehabilitation unit of a United Kingdom 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. Main Outcomes & 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 to 68.64) and FIM-FAM Total scores (OR=0.03; 95% CI: 0.002 to 0.35). Conclusions: There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort.
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