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全身麻醉暴露与痴呆风险:一项全国范围内基于人群的队列研究。

Exposure to General Anesthesia and Risk of Dementia: A Nationwide Population-Based Cohort Study.

机构信息

Institute of Life and Death Studies, Hallym University, Chuncheon, Gangwon-do, Republic of Korea.

Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.

出版信息

J Alzheimers Dis. 2018;63(1):395-405. doi: 10.3233/JAD-170951.

Abstract

BACKGROUND

There is a growing concern that general anesthesia could increase the risk of dementia. However, the relationship between anesthesia and subsequent dementia is still undetermined.

OBJECTIVE

To determine whether the risk of dementia increases after exposure to general anesthesia.

METHODS

A population-based prospective cohort study analyzing the Korean National Health Insurance Service-National Sample Cohort database was conducted of all persons aged over 50 years (n = 219,423) from 1 January 2003 and 31 December 2013.

RESULTS

44,956 in the general anesthesia group and 174,469 in the control group were followed for 12 years. The risk of dementia associated with previous exposure to general anesthesia was increased after adjusting for all covariates such as gender, age, health care visit frequency, and co-morbidities (Hazard ratio = 1.285, 95% confidence interval = 1.262-1.384, time-varying Cox hazard model). In addition, the number of anesthetic agents administered, the number of exposures to general anesthesia, the cumulative exposure time, and the organ category involved in surgery were associated with risk of dementia.

CONCLUSION

In light of the increasing societal burden of dementia, careful surveillance for dementia and prevention guidelines for patients after general anesthesia are needed.

摘要

背景

人们越来越担心全身麻醉会增加痴呆的风险。然而,麻醉与随后发生痴呆之间的关系仍未确定。

目的

确定全身麻醉后痴呆的风险是否会增加。

方法

对 2003 年 1 月 1 日至 2013 年 12 月 31 日期间所有年龄在 50 岁以上(n=219423)的人进行了一项基于人群的前瞻性队列研究,分析了韩国国家健康保险服务-国家抽样队列数据库。

结果

全麻组 44956 例,对照组 174469 例,随访 12 年。在调整了性别、年龄、就诊频率和合并症等所有混杂因素后,先前暴露于全身麻醉与痴呆风险相关(风险比=1.285,95%置信区间 1.262-1.384,时变 Cox 风险模型)。此外,麻醉药物的使用数量、全身麻醉的暴露次数、累积暴露时间以及手术涉及的器官类别与痴呆风险相关。

结论

鉴于痴呆的社会负担不断增加,需要对接受全身麻醉后的患者进行痴呆的密切监测和预防指南。

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