Çobas M, Demir ZA, Aykut A, et al. J Cardiothorac Vasc Anesth. 2026;40(9):2761-2772.
Turkey
Perioperative avoidance of anticholinergic anaesthetic/analgesic drugs improved 90-day independence and frailty outcomes versus standard care: full Katz independence 75.0% vs 41.1% (p<0.001); median CFS 3 vs 4 (p<0.001). Anticholinergic exposure independently predicted total complications (OR 2.43, 95% CI 1.03-5.73).
Single-centre; specific CABG population; open-label design; modest sample; perioperative drug strategy may not translate directly to medical/frailty populations; complication association partly observational within trial context.
Adults ≥60 years undergoing CABG with preoperative Anticholinergic Cognitive Burden score ≥3
This is one of the clearest recent signals that anticholinergic burden may be modifiable in an acute perioperative pathway, with functional—not just cognitive—benefit. It supports reviewing avoidable anticholinergic exposure in older surgical patients, but a single-centre trial in CABG patients is not enough to generalise routine practice across all frailty settings.