The use of anticholinergic medication is associated with an increased risk of stroke-associated pneumonia

Background Pneumonia is a frequent medical complication after stroke. A few studies showed that the use of anticholinergic medication is associated with a higher risk of community acquired pneumonia in the elderly. We aimed to determine if there is any association between anticholinergic medication used before stroke and stroke-associated pneumonia (SAP). Methods We analysed prospectively collected data of 675 patients with acute stroke (mean age 71.4 +/- 13.3; 53.1% female). We used the Anticholinergic Drug Scale to assess anticholinergic exposure during a month preceding stroke onset. Results We diagnosed SAP in 14.7% of patients. The use of anticholinergic medication was associated with an elevated risk of SAP (OR 2.56, 95% CI 1.59-4.11, P < 0.01) in univariate analysis. This association remained significant in multivariable analysis adjusted for age, stroke severity, atrial fibrillation, previous myocardial infarction and respiratory tract diseases (OR 2.06, 95% CI 1.01-4.22, P = 0.04). Conclusions The use of anticholinergic medication before stroke is associated with an increased risk of SAP.

Automated summary

The study found that the use of anticholinergic medication before stroke is associated with an increased risk of stroke-associated pneumonia (SAP), suggesting that the use of anticholinergic medication may increase the risk of pneumonia after a stroke.