Increased risk of dementia in people with previous exposure to general anesthesia: A nationwide population-based case control study
Increased risk of dementia in people with previous exposure to general anesthesia: A nationwide population-based case control study
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DOI：
10.1016/j.jalz.2013.05.1766
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发表时间：
2014-03-01
影响因子：
14
通讯作者：
Chung, Chi-Jung
中科院分区：
文献类型：
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作者：
Chen, Chia-Wen;Lin, Che-Chen;Chung, Chi-Jung
背景：痴呆是发生在老年人群中的重要疾病之一，是导致残疾的主要原因。然而，这种疾病的确切机制仍不清楚。全麻(GA)在痴呆发病中的潜在危险因素是一个有争议的话题。因此，本研究旨在评估既往接触不同遗传基因型别与痴呆症发病的关系。方法：利用2005-2009年台湾全民健保100万参保居民的申领资料，将5345名50岁以上的新诊断痴呆症患者纳入研究组。对照组由21,380名非痴呆症患者组成，他们在年龄、性别和索引日期方面进行了匹配。GA分为三种亚型：气管插管全麻(ETGA)、静脉注射全麻(IVGA)或肌肉注射全麻(IMGA)和重度镇静。结果：在剂量反应关系中，接受ETGA手术的个体(优势比[OR]1.34；95%可信区间[CI]，1.25~1.44)和接受iVGA或IMGA手术的个体(OR，1.28；95%CI，1.14 1.43)患痴呆的风险显著增加(P
Background: Dementia, which leads to disability, is one of the important diseases occurring among older populations. However, the exact mechanism of the disease remains unknown. The potential risk factor of general anesthesia (GA) in the development of dementia is a controversial topic. Therefore, this study aimed to evaluate the association between previous exposure to different GA types and the incidence of dementia.Methods: Using the claims data of 1 million insured residents covered by Taiwan's universal health insurance from 2005 to 2009, 5345 newly diagnosed dementia patients older than 50 years were eligible for the study group. The control group, which consisted of 21,380 individuals without dementia, was matched for age, gender, and index date. GA was categorized into three subtypes: endotracheal tube intubation general anesthesia (ETGA), intravenous injection general anesthesia (IVGA) or intramuscular injection general anesthesia (IMGA), and heavy sedation. The multiple logistic regression model was used for analyses.Results: Individuals exposed to surgery under ETGA (odds ratio [OR], 1.34; 95% confidence interval [Cl], 1.25-1.44) and those exposed to surgery under IVGA or IMGA (OR, 1.28; 95% Cl, 1.14 1.43) were at significantly higher risk of dementia in a dose response relationship (P