The Relationship Between Anticholinergic Burden and Postoperative Complications After Cardiac Surgery in Older Adults

Study Overview
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Brief Summary
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Drugs with anticholinergic properties are widely prescribed in the elderly population, despite increasing evidence in the literature regarding side effects and adverse outcomes. As is known, many drugs have anticholinergic activity, which means that they block the binding of the neurotransmitter acetylcholine to the muscarinic receptor. In this case, the occurrence of anticholinergic side effects becomes inevitable. Central effects such as cognitive impairment, dizziness, sedation, confusion or delirium, and peripheral effects such as dry mouth, dry eyes, constipation, urinary retention, and tachycardia begin to be seen in patients. Anticholinergic load refers to the cumulative effect of taking one or more drugs with anticholinergic activity. This cumulative effect is a strong indicator of cognitive and physical deterioration, especially in the elderly population. It is also associated with adverse outcomes such as falls, impaired functioning, and higher rates of hospitalization and death. Anticholinergic load scales include scales that facilitate the work of physicians used in clinical practice to predict anticholinergic side effects in humans. Although there are many different scales used at this point, one of the scales with the highest validity and reliability in recent studies are Anticholinergic cognitive burden scale (ACB) and Anticholinergic risk scale (ARS). To the best of our knowledge, we could not find any study on postoperative complications, length of hospital stay and mortality after cardiac surgery with these scales. Therefore, we aimed to examine the relationship between possible complications after cardiac surgery and anticholinergic load scales showing the cumulative effect of preoperative drugs.

Official Title
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The Relationship Between Anticholinergic Burden and Postoperative Complications After Cardiac Surgery in Older Adults

Conditions
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Postoperative Complications

Intervention / Treatment
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* Procedure: cardiac surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: It is planned to include patients over the age of 65 who underwent cardiac surgery in the research population. Gender discrimination will not be considered. Exclusion Criteria: Those who are under the age of 65, Those who have non-cardiac surgery, Those whose drug records cannot be accessed

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| High anticholinergic burden<br>ACB scale score 1 or >1 as a high anticholinergic buden | Procedure: cardiac surgery<br>* cardiovascular surgery including valve repair/replacement or CABG or combined procedures<br>|
| Normal anticholinergic burden<br>ACB scale score <1 as a control group | Procedure: cardiac surgery<br>* cardiovascular surgery including valve repair/replacement or CABG or combined procedures<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative complication | Dindo classification | 1 month fellow-up |