■痴呆症是由于大脑中的神经细胞受损而导致的逐渐和持续的认知能力下降。这项荟萃分析旨在评估区域麻醉(RA)与痴呆风险之间的潜在关系。
■电子数据库,包括Embase,Medline,谷歌学者,从开始至2022年3月,我们搜索了Cochrane图书馆调查RA与痴呆风险之间关联的研究.主要结果是接受RA(RA组)和接受全身麻醉(GA组)的患者患痴呆的风险。次要结果包括确定痴呆的其他潜在危险因素,并比较接受RA和未接受手术/麻醉的个体之间的痴呆风险(安慰剂组)。
■本分析包括2014年至2023年发表的8项队列研究。对现有数据的荟萃分析表明,基线特征和发病率没有差异(即,年龄,男性比例,高血压,糖尿病,抑郁症,RA和GA组之间的严重合并症)(均p>0.05)。初步分析表明,GA组的痴呆风险高于RA组(HR=1.81,95%CI=1.29-2.55,p=0.007,I2=99%,五项研究)。然而,当一项以相对年轻人群为特征的研究被排除在敏感性分析之外时,结果显示痴呆的风险相似(HR,1.17;p=0.13)在GA和RA组之间。汇总结果显示RA和安慰剂组之间的痴呆风险没有差异(HR=1.2,95%CI=0.69-2.07,p=0.52,I2=68%,三项研究)。敏感性分析显示证据不稳定,这表明有限的数据集排除了关于这一结果的强有力的结论。焦虑,中风史,高血压,糖尿病,高脂血症,糖尿病是痴呆的潜在预测因子。
■我们的研究结果强调,虽然与GA相比,RA可以预防痴呆风险,不同年龄段的麻醉类型与痴呆风险之间的关联可能有所不同.由于痴呆症在老年人中的患病率和他们的手术需求,需要进一步的研究来阐明痴呆风险与区域麻醉之间的关联.系统审查注册:https://www。crd.约克。AC.英国/普华永道/,CRD42023411324。
UNASSIGNED: Dementia is a gradual and ongoing cognitive decline due to damage to nerve cells in the brain. This meta-analysis aimed to assess the potential relationship between regional anesthesia (RA) and the risk of dementia.
UNASSIGNED: Electronic databases including Embase, Medline, Google Scholar, and Cochrane Library were searched for studies investigating the association between RA and dementia risk from inception to March 2022. The primary outcome was the risk of dementia in patients who underwent RA (RA group) and those who received general anesthesia (GA group). Secondary outcomes included identifying other potential risk factors for dementia and comparing dementia risk between individuals receiving RA and those not receiving surgery/anesthesia (placebo group).
UNASSIGNED: Eight cohort studies published between 2014 and 2023 were included in this analysis. A meta-analysis of the available data demonstrated no differences in baseline characteristics and morbidities (i.e., age, male proportion, hypertension, diabetes, depression, and severe comorbidities) between the RA and GA groups (all p > 0.05). Initial analysis revealed that the risk of dementia was higher in the GA group than in the RA group (HR = 1.81, 95% CI = 1.29-2.55, p = 0.007, I 2 = 99%, five studies). However, when a study featuring a relatively younger population was excluded from the sensitivity analysis, the results showed a similar risk of dementia (HR, 1.17; p = 0.13) between the GA and RA groups. The pooled results revealed no difference in dementia risk between the RA and placebo groups (HR = 1.2, 95% CI = 0.69-2.07, p = 0.52, I 2 = 68%, three studies). Sensitivity analysis revealed that the evidence was not stable, suggesting that limited datasets precluded strong conclusions on this outcome. Anxiety, stroke history, hypertension, diabetes, hyperlipidemia, and diabetes are potential predictors of dementia.
UNASSIGNED: Our results emphasize that, while RA could be protective against dementia risk compared to GA, the association between the type of anesthesia and dementia risk might vary among different age groups. Owing to the significant prevalence of dementia among older people and their surgical needs, further investigations are warranted to clarify the association between dementia risk and regional anesthesia.Systematic review registration: https://www.crd.york.ac.uk/prospero/, CRD42023411324.