PP235
ASSOCIATION BETWEEN ANTICHOLINERGIC MEDICATION BURDEN AND ASPIRATION PNEUMONIA IN HOSPITALIZED ADULTS MANAGED WITH ENTERAL TUBE FEEDING OR TOTAL PARENTERAL NUTRITION
E. Gecegelen1,*, M. Aslan Yeter1, C. Kayabaşı1, Y. N. Doğancı2, F. Tamer2, N. Erten2, P. Onar2, S. Ataç2, B. Kelleci Çakır3, A. M. Vural4, C. Balcı1, E. Ortaç Ersoy5, K. Demirkan3, M. Gülhan Halil1
1Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University, 2Nutritional Support Department, Hacettepe University Hospital, 3Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, 4Department of Anesthesiology and Reanimation, Intensive Care Unit , 5Department of Internal Medicine, Intensive Care Unit, Hacettepe University , Ankara, Türkiye
Rationale: Anticholinergic medications may reduce salivary secretion, thereby potentially increasing the risk of aspiration pneumonia(AP) in hospitalized older adults requiring nutritional support.
Methods: This retrospective cohort study included 192 hospitalized adults >60 years of age without AP at admission. Patients were grouped according to the nutritional support strategy applied at hospitalization: those treated with total parenteral nutrition (TPN) only and those who underwent enteral tube feeding . Medication burden before hospitalization and after 1 week of in-hospital medication use was assessed using the Anticholinergic Cognitive Burden (ACB) scale and Drug Burden Index(DBI). Multivariable logistic regression was performed to identify factors independently associated with AP.
Results: Aspiration pneumonia developed in 30 of 192 patients(15.6%). Patients with AP more frequently received enteral nutritional support (60.0% vs 32.7%, p=0.004), but hospital stay did not differ significantly(p=0.062). Pre-hospital DBI category differed between groups(p=0.029), and in-hospital DBI category was associated with AP(Figure 1). In contrast, neither pre-hospital ACB category (p=0.087) nor in-hospital ACB categories were associated with AP(Figure 2). In multivariable analysis, male sex (OR 2.800, 95% CI 1.097–7.147; p=0.031), in-hospital DBI risk (OR 3.111, 95% CI 1.101–8.789; p=0.032), and enteral tube feeding versus TPN (OR 3.122, 95% CI 1.355–7.194;p=0.007) were independently associated with AP, whereas length of stay was not(Figure 3).
Image:
Conclusion: In hospitalized older adults receiving nutritional support, male sex, enteral tube feeding, and higher DBI risk after 1 week of in-hospital medication exposure were independently associated with AP, whereas ACB was not, suggesting DBI may be a more useful predictor of aspiration risk in this setting.
Disclosure of Interest: None declared