Yang Ya-Ling, Chang Jung-Chan, Ho Shu-Chen, Yeh Chien-Ning, Kuo Ho-Chang
Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 833, Taiwan.
Department of Data Science and Analytics, I-Shou University, Kaohsiung 840, Taiwan.
Children (Basel). 2023 Mar 27;10(4):626. doi: 10.3390/children10040626.
Few studies have focused on the consequence of exposure to general anesthesia (GA) in children's early life with the risk of asthma and disease outcomes. The present study examines the correlation between exposure to GA under three years old and the subsequent course of asthma in a nationwide population-based cohort study. Our cases were acquired from Taiwan's National Health Insurance Research Database (NHIRD). Children under three years old with either GA exposure or not during in-patient treatment from 1997 to 2008 were included. The study group was age- and sex-matched with a ratio of 1:2 to create the control group for comparison. The cohort included 2261 cases with GA and 4522 cases without GA as a control group. The incidence of asthma onset was significantly reduced in patients with GA exposure under 3 three years old (hazard ratio 0.64 (95% confidence interval 0.57~0.72), < 0.001). In addition, regardless of whether the asthmatic clinical visits were before or after GA exposure, asthma onset patients before GA exposure have significantly fewer clinical visits than those without GA exposure (both 0.001, respectively). Using the Kaplan-Meier method, we also demonstrated that GA exposure was associated with favorable clinical visits in patients with asthma, whether their asthma was onset before GA ( = 0.0102) or after GA exposure ( 0.0418) compared to non-GA-exposed controls. In the present study, we demonstrated that children with early GA exposure under three years old were at a reduced risk of developing asthma compared to the general population. Furthermore, we first reported that GA exposure significantly reduced clinical visits in patients with asthma regardless of whether their asthma onset was before or after GA exposure. It is indicated that GA exposure at a younger age could have potential clinical benefits for asthma than non-GA-exposed controls.
很少有研究关注儿童早期接触全身麻醉（GA）与哮喘风险和疾病转归之间的关系。本项基于全国人群的队列研究，探讨三岁以下儿童接触GA与随后哮喘病程之间的相关性。我们的研究病例来自台湾国民健康保险研究数据库（NHIRD）。纳入1997年至2008年住院治疗期间有或无GA接触史的三岁以下儿童。研究组按年龄和性别以1:2的比例匹配，形成对照组进行比较。该队列包括2261例有GA接触史的病例和4522例无GA接触史的病例作为对照组。三岁以下有GA接触史的患者哮喘发病风险显著降低（风险比0.64（95%置信区间0.57~0.72），<0.001）。此外，无论哮喘临床就诊是在GA接触之前还是之后，GA接触之前发病的哮喘患者临床就诊次数均显著少于无GA接触史的患者（均P<0.001）。使用Kaplan-Meier方法，我们还证明，与未接触GA的对照组相比，GA接触与哮喘患者的良好临床就诊相关，无论其哮喘是在GA接触之前（P = 0.0102）还是之后（P = 0.0418）发病。在本研究中，我们证明三岁以下早期接触GA的儿童患哮喘的风险低于一般人群。此外，我们首次报告，无论哮喘发病是在GA接触之前还是之后，GA接触均显著减少哮喘患者的临床就诊次数。这表明，与未接触GA的对照组相比，幼年接触GA对哮喘可能具有潜在的临床益处。
