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全身麻醉与痴呆症发病风险增加之间关联的纵向研究

Longitudinal Study of the Association between General Anesthesia and Increased Risk of Developing Dementia.

作者信息

Sohn Jong-Hee, Lee Jae Jun, Lee Sang-Hwa, Kim Chulho, Yu Hyunjae, Kwon Young-Suk, Kim Dong-Kyu

机构信息

Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.

Division of Big Data and Artificial Intelligence, Institute of New Frontier Research, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea.

出版信息

J Pers Med. 2021 Nov 16;11(11):1215. doi: 10.3390/jpm11111215.

Abstract

The association between exposure to general anesthesia (GA) and the risk of dementia is still undetermined. To investigate a possible link to the development of dementia in older people who have undergone GA, we analyzed nationwide representative cohort sample data from the Korean National Health Insurance Service. The study cohort comprised patients over 55 years of age who had undergone GA between January 2003 and December 2004 and consisted of 3100 patients who had undergone GA and 12,400 comparison subjects who had not received anesthesia. After the nine-year follow-up period, we found the overall incidence of dementia was higher in the patients who had undergone GA than in the comparison group (10.5 vs. 8.8 per 1000 person-years), with the risk being greater for women (adjusted HR of 1.44; 95% CI, 1.19-1.75) and those with comorbidities (adjusted HR of 1.39; 95% CI, 1.18-1.64). Patients who underwent GA showed higher risks for Alzheimer's disease and vascular dementia (adjusted HR of 1.52; 95% CI, 1.27-1.82 and 1.64; 95% CI, 1.15-2.33, respectively). This longitudinal study using a sample cohort based on a nationwide population sample demonstrated a significant positive association between GA and dementia, including Alzheimer's disease and vascular dementia.

摘要

全身麻醉(GA)暴露与痴呆风险之间的关联仍未确定。为了研究接受GA的老年人患痴呆症的可能联系,我们分析了韩国国民健康保险服务中心具有全国代表性的队列样本数据。研究队列包括2003年1月至2004年12月期间接受GA的55岁以上患者,由3100名接受GA的患者和12400名未接受麻醉的对照对象组成。经过九年的随访期,我们发现接受GA的患者中痴呆症的总体发病率高于对照组(每1000人年分别为10.5例和8.8例),女性(调整后HR为1.44;95%CI,1.19 - 1.75)和患有合并症的患者(调整后HR为1.39;95%CI,1.18 - 1.64)风险更高。接受GA的患者患阿尔茨海默病和血管性痴呆的风险更高(调整后HR分别为1.52;95%CI,1.27 - 1.82和1.64;95%CI,1.15 - 2.33)。这项基于全国人口样本的样本队列的纵向研究表明,GA与痴呆症(包括阿尔茨海默病和血管性痴呆)之间存在显著的正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/006a/8624274/937fc6c9ae8f/jpm-11-01215-g001.jpg

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