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Dementia Risk after Major Surgery Based on the Type of Anesthesia: A Propensity Score–Matched Population-Based Cohort Study
34 Pages Posted: 15 Jun 2022
More...Abstract
Purpose: Whether the type of anesthesia is an independent risk factor for dementia remains unclear. Therefore, we conducted a propensity score (PS)–matched (PSM) population-based cohort study to compare dementia incidence among surgical patients undergoing different types of anesthesia.
Patients and Methods: The patients undergoing major surgery were categorized into three groups according to non-inhalation anesthesia, inhalation anesthesia, or regional anesthesia (regional anesthesia), matched at a 1:1 ratio. The incidence rate (IR) of dementia was determined.
Results: PSM yielded 63,750 patients (21,250 in the non-inhalation anesthesia group, 21,250 in the inhalation anesthesia group, and 21,250 in the regional anesthesia group). In the multivariate Cox regression analysis, compared with the regional anesthesia group, the adjusted hazard ratios (aHRs) (95% confidence interval [CI]) of dementia risk of the inhalation and non-inhalation anesthesia groups compared with the regional anesthesia group were 20.18 (15.44–26.37; p<0.001) and 18.38 (14.06–24.01; p<0.001). The aHR of dementia risk of inhalation anesthesia compared with non-inhalation anesthesia was 1.12 (1.02–1.21; p=0.031). The IRs of dementia for the inhalation, non-inhalation, and regional anesthesia groups were 3647.90, 3492.00, and 272.99 per 100,000 person-years, respectively.
Conclusion: The incidence of dementia among surgical patients undergoing GA was higher than those undergoing regional anesthesia. Surgical patients undergoing inhalation anesthesia were associated with a higher risk of dementia compared with those undergoing non-inhalation anesthesia.
Funding Information: This study was supported by Lo-Hsu Medical Foundation, LotungPoh-Ai Hospital, supports SzuYuan Wu’s work (Funding Number: 11001, 11010, 11013 and 11103).
Declaration of Interests: The authors have no potential conflicts of interest to declare.
Ethics Approval Statement: The study protocols were reviewed and approved by the Institutional Review Board of Tzu-Chi Medical Foundation (IRB109-015-B).
Keywords: anesthesia, dementia, incidence rate, general anesthesia, regional anesthesia
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