| Summary: | 碩士 === 國立成功大學 === 臨床藥學研究所 === 97 === Background
Acute urinary retention (AUR) is a common clinical emergent condition. The incidence of AUR increases with ages. Drugs with potent anticholinergic properties are not inappropriate for elderly patients according to Beers’ criteria. These drugs include first-generation antihistamines, tricyclic antidepressant agents, antispasmodics, and muscle relaxants. However, these medicines are still widely used among elderly patients. Therefore, the aim of this study is to evaluate the association between antihistamines and AUR in elderly patients.
Method
The data source is from non-sampled National Health Insurance in 2003~2004. The case group was defined as elderly patients with the first AUR event between 1 Jan 2004 and 31 Dec 2004. The control group is defined as elderly patients without AUR during 2004. Control subjects were matched to cases for age (±3years), gender, area, hospital level, the date of case included, and benign prostatic hyperplasia. After matching, we analyzed the risk of AUR in elderly patients who took antihistamines. The use of antihistamines is defined as current use (antihistamines within 7 days), past use (within 8~30 days) and no use (did not use antihistamines within 30 days).
Result
We identified 5,164 case patients and 36,894 control patients after matching. More patients have covariant factors of cardiac disease (27.35%), diabetes mellitus (18.55%), and NSAID (17.88%). Current antihistamine use was associated with an increased risk of AUR (adjusted OR, 2.220 [95% CI, 1.981~2.488]). Both first-generation (adjusted OR, 2.746 [95% CI, 2.408~3.132]) and second-generation (adjusted OR, 1.385 [95% CI, 1.108~1.731]) antihistamine use increased the risk of AUR significantly. Compare to first-generation antihistamines, second-generation antihistamines had lower risk of AUR (adjusted OR, 0.384 [95% CI, 0.197~0.748]).
Conclusion
Both first-generation and second-generation antihistamine therapy in the elderly patients within 7 days were associated with an increased risk of AUR. In addition, second-generation antihistamines had lower risk of AUR compared with first-generation antihistamines.
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