{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:32:51Z","timestamp":1793179971719,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Anticholinergic medications are frequently prescribed to older adults and are associated with adverse outcomes including cognitive impairment, delirium and mortality. In patients with hip fracture\u2014a population characterized by frailty and polypharmacy\u2014the impact of anticholinergic burden on survival remains uncertain. This study aimed to examine the association between anticholinergic burden and all\u2010cause mortality after hip fracture in adults aged \u226565\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis was conducted according to PRISMA 2020 guidelines (PROSPERO CRD420251181616). PubMed, Embase, Scopus and Cochrane Library were searched through September 2025. Observational studies assessing mortality by validated anticholinergic burden scales\u2014Anticholinergic Cognitive Burden (ACB), Anticholinergic Risk Scale (ARS) or Drug Burden Index (DBI)\u2014were included. Pooled hazard ratios (HR) with 95% confidence intervals were calculated using a random\u2010effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five cohort studies including 65\u2009435 patients met inclusion criteria. High anticholinergic burden was associated with increased 12\u2010month (HR\u2009=\u20091.47; 95% CI 1.11\u20131.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and 36\u2010month mortality (HR\u2009=\u20091.45; 95% CI 1.05\u20132.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). No significant association was observed at 1\u20136\u00a0months. Overall, pooled analysis showed a 40% higher mortality risk in patients with high anticholinergic burden (HR\u2009=\u20091.40; 95% CI 1.22\u20131.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Heterogeneity was high, and the certainty of evidence ranged from low to very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher anticholinergic burden was associated with an increased risk of medium\u2010 and long\u2010term mortality after hip fracture in older adults. Routine assessment and reduction of anticholinergic exposure should be incorporated into perioperative geriatric management to improve survival outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70780","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:45:52Z","timestamp":1786693552000},"page":"3707-3715","source":"Crossref","is-referenced-by-count":0,"title":["Higher anticholinergic burden is associated with increased medium\u2010 and long\u2010term mortality following hip fracture: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-9877","authenticated-orcid":false,"given":"Alejandro","family":"Valcuende\u2010Rosique","sequence":"first","affiliation":[{"name":"Department of Pharmacy Hospital Padre Jofre  Valencia Spain"},{"name":"Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir  Valencia Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fragilidad y Envejecimiento Saludable (CIBERFES)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa Garc\u00eda","family":"Tercero","sequence":"additional","affiliation":[{"name":"Geriatric Medicine Department Hospital Universitario de la Ribera  Alzira Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Navalon","family":"Bono","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Hospital Universitario de la Ribera  Alzira Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn","family":"Borr\u00e1s\u2010Blasco","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Hospital de Sagunto  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel Belenguer","family":"Varea","sequence":"additional","affiliation":[{"name":"Geriatric Medicine Department Hospital Universitario de la Ribera  Alzira Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Mar\u00eda","family":"De la C\u00e1mara\u2010de Las Heras","sequence":"additional","affiliation":[{"name":"Library Service Hospital Universitario la Ribera  Alzira Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena Linge","family":"Martin","sequence":"additional","affiliation":[{"name":"Geriatric Medicine Department Hospital Universitario de la Ribera  Alzira Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9","family":"Tarazona\u2010Santabalbina","sequence":"additional","affiliation":[{"name":"Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir  Valencia Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Fragilidad y Envejecimiento Saludable (CIBERFES)  Madrid Spain"},{"name":"Geriatric Medicine Department Hospital Universitario de la Ribera  Alzira Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2018.04.015"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520\u2010019\u201001134\u20105"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001772"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)00516\u20104"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/20420986211016645"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.00570"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/fcp.12560"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.19570"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2025.105537"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2023.05.014"},{"key":"e_1_2_8_12_1","unstructured":"KingR RabinoS.ACB calculator. 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