Cardiothoracic & vascular anaesthesia
Anticholinergic Burden as a Modifiable Risk Factor in Cardiac Surgery: A Randomized Controlled Study
Authors' conclusion
In older CABG patients, immediate perioperative deprescribing of anticholinergic medications improved 90-day functional recovery trajectories and was associated with fewer cardiac and pulmonary complications.
Study context
- Population
- Patients aged ≥60 years undergoing coronary artery bypass grafting (CABG) with preoperative Anticholinergic Cognitive Burden scores ≥3
- Participants
- 122 patients
- Comparison
- Deprescribing vs Standard
- Primary endpoint
- Functional recovery assessed using the Katz Index and the Clinical Frailty Scale
- Follow-up
- POD 90
Methodological detailsprospective, single-centre
- Prospective
- Single-centre
Primary result
As reported in the abstract
Full independence (Katz Index score of 6)
P < 0.001
Further findings
Median
| Outcome | Deprescribing | Standard | P value |
|---|---|---|---|
| Clinical Frailty Scale score (co-primary) · 90 days | 3 (IQR 3–3) | 4 (IQR 3–4) | P < 0.001 |
Within-group change from baseline to day 90
- Deprescribing: decreased frailty scores and increased Katz Index scores
- P < 0.001 for both
- Standard: increased frailty
- P < 0.001
- Standard: no significant change in Katz Index scores
- P = 0.317
Safety
90-day total complications (perioperative anticholinergic anaesthetic and analgesic drug use as predictor)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Perioperative anticholinergic drug useMultivariate logistic regression; independent predictor | 2.430 (1.031–5.726) | P = 0.042 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Anticholinergic Burden as a Modifiable Risk Factor in Cardiac Surgery: A Randomized Controlled Study. J Cardiothorac Vasc Anesth. Published 8 May 2026. doi:10.
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