Is there an increased risk of delirium among patients with overactive bladder treated with newer anticholinergic medication compared to a beta-3 agonist?
Bibliographic record
Abstract
ABSTRACT\nObjective\nTo determine if there is an increased risk of delirium among patients with overactive bladder (OAB) started on anticholinergic medication compared to beta-3 agonist.\nMethods\nWe conducted a population-based, retrospective, matched weight cohort study using administrative data from Ontario, Canada from January 2016 until March 2020. We matched 13865 new users of Oxybutynin to 33097 new users of newer anticholinergic medications (Solifenacin, Tolterodine, Trospium, Darifenacin and Fesoterodine), and to 56062 new users of beta-3 agonist medication (Mirabegron); all of the included medications are only for the treatment of OAB. Matching weights (an extension of the propensity score weighting) were used to balance the three exposure groups based on 83 measured indicators of baseline health, comorbidity, medication usage and health care utilization. The primary exposure was the class of OAB medication (Oxybutynin, Newer anticholinergics, and Beta-3 agonist). The primary outcome was delirium using a validated administrative data definition. Logistic regression, and proportional hazards analysis were used to assess outcomes at 30 days, and during continuous use of the medications.\nResults\nThe median (IQR) duration of continuous usage was 113 (30-380) days for Beta-3 agonist, 30 (28-72) days for Oxybutynin, and 62 (30-239) days for the newer anticholinergics. There was no increased risk of delirium in primary analysis among Oxybutynin and newer anticholinergics drug users compared to beta-3 agonist at the 30 days observational window (odds ratio 1.28, 95% CI 0.84-1.96, p=0.25 for Oxybutynin and OR 0.92, 95% CI 0.58-1.46, p=0.73 for newer anticholinergics). The secondary analysis accounting for the period of continuous use showed a small but significant increased risk of delirium with the use of newer anticholinergics drugs compared to beta-3 agonist (HR 1.13, 95% CI 1.02-1.26 for newer anticholinergics).\nConclusions\nThe use of anticholinergic medications among patients with OAB was not associated with increased risk of delirium compared to beta-3 agonist users at 30 days; however, the risk might be slightly increased with continuous usage of newer anticholinergic medications.\nKeywords\nOveractive Bladder, Delirium, Anticholinergics, Population-based.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".