Analysis of Anticholinergic Drug-Related Urinary Retention Risk Using the Japanese Anticholinergic Risk Scale

Abstract

Objective: Urinary retention, commonly seen in older adults, can result from both underlying diseases and the use of anticholinergic medications. Given the widespread issue of polypharmacy in this population, the identification of predictive markers for drug-induced complications is critical. This study examined the relationship between urinary retention and the Japanese Anticholinergic Risk Scale, with the aim of supporting its clinical relevance.

Methods: Hospitalized patients from January 1, 2022, to December 31, 2023, were included and categorized by urinary retention status. Propensity score matching adjusted for age, sex, admission activities of daily living, and comorbidities was performed. We used logistic regression to assess the association between urinary retention and total Japanese Anticholinergic Risk Scale scores. Patients were stratified into LOW (scores of 1-3) and HIGH (scores of ≥ 4) groups.

Results: Of 10,191 patients, 903 with urinary retention were matched to 903 without. In the group with a Japanese Anticholinergic Risk Scale score of 4, the odds ratio was 2.28 (p＝0.007). In addition, in the HIGH group the odds ratio was 1.65 (p＝0.019), showing a significant association.

Discussion: These findings suggest that a Japanese Anticholinergic Risk Scale score ≥ 4 reflects increased risk of urinary retention due to cumulative anticholinergic burden. Comprehensive risk assessment using Japanese Anticholinergic Risk Scale may help prevent anticholinergic-related adverse events.

Conclusion: A Japanese Anticholinergic Risk Scale score ≥ 4 was significantly associated with urinary retention, highlighting the impact of cumulative anticholinergic effects.