Abstract：
BACKGROUND: Dementia is a prevalent neurological condition, yet the relationship between dementia and general anesthesia remains uncertain. The study aimed to explore the association between general anesthesia and dementia using a nationwide population-based database.
METHODS: The study extracted data from Taiwan\'s national health insurance, which encompassed the records of one million insured residents. A total of 59,817 patients aged 65 years and above, diagnosed with osteoarthritis between 2002 and 2010, were included. Among these patients, 3277 individuals with an initial diagnosis of dementia between 2004 and 2013 were matched with non-dementia patients based on age, gender, and the date of osteoarthritis diagnosis. Following a 1:2 random matching, the case group included 2171 patients with dementia, while the control group consisted of 4342 patients without dementia. The data was analyzed using conditional and unconditional logistic regressions.
RESULTS: No significant differences in the odds of dementia were found between individuals exposed to general and regional anesthesia during hip/knee replacement surgeries (OR = 1.11; 95%CI: 0.73-1.70), after adjusting for age, sex, and co-morbidities. Similarly, there were no significant differences in the odds of dementia based on different durations of anesthesia exposure (General: <2 h: OR = 0.91, 95%CI = 0.43-1.92; 2-4 h: OR = 1.21, 95%CI = 0.82-1.79; >4 h: OR = 0.39, 95%CI = 0.15-1.01; compared to no exposure. Regional: <2 h: OR = 1.18, 95%CI = 0.85-1.62; 2-4 h: OR = 0.9, 95%CI = 0.64-1.27; >4 h: OR = 0.55, 95%CI = 0.15-1.96; compared to no exposure). Likewise, no significant differences were observed in the odds of dementia based on the number of replacement surgeries (twice: OR = 0.74, 95%CI = 0.44-1.23, compared to once).
CONCLUSIONS: Neither general anesthesia nor regional anesthesia in hip/knee surgery was associated with dementia. Different numbers and durations of anesthesia exposure showed no significant differences in the odds for dementia.
METHODS: The study extracted data from Taiwan\'s national health insurance, which encompassed the records of one million insured residents. A total of 59,817 patients aged 65 years and above, diagnosed with osteoarthritis between 2002 and 2010, were included. Among these patients, 3277 individuals with an initial diagnosis of dementia between 2004 and 2013 were matched with non-dementia patients based on age, gender, and the date of osteoarthritis diagnosis. Following a 1:2 random matching, the case group included 2171 patients with dementia, while the control group consisted of 4342 patients without dementia. The data was analyzed using conditional and unconditional logistic regressions.
RESULTS: No significant differences in the odds of dementia were found between individuals exposed to general and regional anesthesia during hip/knee replacement surgeries (OR = 1.11; 95%CI: 0.73-1.70), after adjusting for age, sex, and co-morbidities. Similarly, there were no significant differences in the odds of dementia based on different durations of anesthesia exposure (General: <2 h: OR = 0.91, 95%CI = 0.43-1.92; 2-4 h: OR = 1.21, 95%CI = 0.82-1.79; >4 h: OR = 0.39, 95%CI = 0.15-1.01; compared to no exposure. Regional: <2 h: OR = 1.18, 95%CI = 0.85-1.62; 2-4 h: OR = 0.9, 95%CI = 0.64-1.27; >4 h: OR = 0.55, 95%CI = 0.15-1.96; compared to no exposure). Likewise, no significant differences were observed in the odds of dementia based on the number of replacement surgeries (twice: OR = 0.74, 95%CI = 0.44-1.23, compared to once).
CONCLUSIONS: Neither general anesthesia nor regional anesthesia in hip/knee surgery was associated with dementia. Different numbers and durations of anesthesia exposure showed no significant differences in the odds for dementia.
摘要：
背景：痴呆是一种普遍的神经系统疾病，然而痴呆与全身麻醉之间的关系仍不确定.该研究旨在使用全国人群数据库探索全身麻醉与痴呆之间的关联。
方法：该研究从台湾的国民健康保险中提取数据，其中包含了100万投保居民的记录。共有59,817名65岁及以上的病人,在2002年至2010年期间被诊断为骨关节炎。在这些患者中,在2004年至2013年之间，有3277名初步诊断为痴呆症的个体与非痴呆症患者的年龄相匹配。性别,和骨关节炎诊断的日期。在1:2随机匹配之后，病例组包括2171例痴呆患者，而对照组为4342例无痴呆患者。使用条件和无条件逻辑回归分析数据。
结果：在髋关节/膝关节置换手术中暴露于全身麻醉和区域麻醉的个体之间，痴呆的几率没有显着差异（OR=1.11；95CI：0.73-1.70），在调整了年龄之后，性别,和合并症。同样，不同麻醉暴露持续时间的痴呆几率无显著差异(一般:<2h:OR=0.91,95CI=0.43-1.92;2-4h:OR=1.21,95CI=0.82-1.79;>4h:OR=0.39,95CI=0.15-1.01;与无暴露相比.区域：<2h：OR=1.18，95CI=0.85-1.62；2-4h：OR=0.9，95CI=0.64-1.27；>4h：OR=0.55，95CI=0.15-1.96；与无暴露相比）。同样，根据置换手术次数,痴呆的几率没有显著差异(两次:OR=0.74,95CI=0.44~1.23,与一次相比).
结论：髋关节/膝关节手术的全身麻醉和区域麻醉均与痴呆无关。不同数量和持续时间的麻醉暴露显示痴呆的几率没有显着差异。
方法：该研究从台湾的国民健康保险中提取数据，其中包含了100万投保居民的记录。共有59,817名65岁及以上的病人,在2002年至2010年期间被诊断为骨关节炎。在这些患者中,在2004年至2013年之间，有3277名初步诊断为痴呆症的个体与非痴呆症患者的年龄相匹配。性别,和骨关节炎诊断的日期。在1:2随机匹配之后，病例组包括2171例痴呆患者，而对照组为4342例无痴呆患者。使用条件和无条件逻辑回归分析数据。
结果：在髋关节/膝关节置换手术中暴露于全身麻醉和区域麻醉的个体之间，痴呆的几率没有显着差异（OR=1.11；95CI：0.73-1.70），在调整了年龄之后，性别,和合并症。同样，不同麻醉暴露持续时间的痴呆几率无显著差异(一般:<2h:OR=0.91,95CI=0.43-1.92;2-4h:OR=1.21,95CI=0.82-1.79;>4h:OR=0.39,95CI=0.15-1.01;与无暴露相比.区域：<2h：OR=1.18，95CI=0.85-1.62；2-4h：OR=0.9，95CI=0.64-1.27；>4h：OR=0.55，95CI=0.15-1.96；与无暴露相比）。同样，根据置换手术次数,痴呆的几率没有显著差异(两次:OR=0.74,95CI=0.44~1.23,与一次相比).
结论：髋关节/膝关节手术的全身麻醉和区域麻醉均与痴呆无关。不同数量和持续时间的麻醉暴露显示痴呆的几率没有显着差异。
