Khan Zeeshan Ahmad, Sumsuzzman Dewan Md, Duran Tahiris A, Ju Ling-Sha, Seubert Christoph N, Martynyuk Anatoly E
Department of Anesthesiology, College of Medicine, University of Florida, JHMHC, 1600 SW Archer Road, Gainesville, FL 32610-0254, USA.
Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada.
Biology (Basel). 2025 Feb 13;14(2):197. doi: 10.3390/biology14020197.
Postoperative neurocognitive disorder (PND) is a cognitive decline after general anesthesia and surgery, influenced by preexisting neurodegenerative conditions, stress, and inflammation. Traumatic brain injury (TBI) is linked to a dysregulated stress response, neuroinflammation, and cognitive issues. Patients with TBI often need extracranial surgeries under general anesthesia (GA), which can increase stress, neuroinflammation, and neurodegenerative changes, raising PND risk. We will search databases like Ovid Medline and Embase for studies on cognitive function in patients with mild to moderate TBI who had extracranial surgeries under general anesthesia (GA). Screening and data extraction will be done manually and with AI-assisted tools (ASReview). Study quality will be assessed using the Newcastle-Ottawa Scale. Statistical analyses will include mean differences, odds ratios, and meta-regression, addressing heterogeneity, sensitivity, and publication bias using Stata/SE. By meta-analyzing clinical studies, we aim to determine if TBI and GA/surgery interact to induce PND. We will use various data sources, subgroup analyses, sensitivity analyses, and meta-regression to assess factors like age, gender, and type of GA/surgery. This meta-analysis will enhance our understanding of PND risks, inform clinical practices, and highlight new research directions. The systematic review is registered in PROSPERO (CRD42024510980).
术后神经认知障碍（PND）是指全身麻醉和手术后出现的认知功能下降，受既往神经退行性疾病、应激和炎症的影响。创伤性脑损伤（TBI）与应激反应失调、神经炎症和认知问题有关。TBI患者通常需要在全身麻醉（GA）下进行颅外手术，这会增加应激、神经炎症和神经退行性变化，从而增加PND风险。我们将检索Ovid Medline和Embase等数据库，以查找有关在全身麻醉（GA）下进行颅外手术的轻至中度TBI患者认知功能的研究。筛查和数据提取将通过人工和人工智能辅助工具（ASReview）完成。研究质量将使用纽卡斯尔-渥太华量表进行评估。统计分析将包括均值差异、比值比和元回归，使用Stata/SE处理异质性、敏感性和发表偏倚。通过对临床研究进行荟萃分析，我们旨在确定TBI与GA/手术是否相互作用导致PND。我们将使用各种数据源、亚组分析、敏感性分析和元回归来评估年龄、性别和GA/手术类型等因素。这项荟萃分析将增进我们对PND风险的理解，为临床实践提供信息，并突出新的研究方向。该系统评价已在PROSPERO（CRD42024510980）注册。
