Association of general anesthesia exposure with risk of postoperative delirium in patients receiving transcatheter aortic valve replacement: a meta-analysis and systematic review

doi:10.1038/s41598-023-43548-2

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Title:	Association of general anesthesia exposure with risk of postoperative delirium in patients receiving transcatheter aortic valve replacement: a meta-analysis and systematic review
Authors:	Ko, Ching-Chung Hung, Kuo-Chuan Chang, Yang-Pei Liu, Chien-Cheng Cheng, Wan-Jung Wu, Jheng-Yan Li, Yu-Yu Lin, Tso-Chou Sun, Cheuk-Kwan
Contributors:	Chi Mei Med Ctr, Dept Med Imaging Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Chi Mei Med Ctr, Dept Anesthesiol Natl Sun Yat Sen Univ, Coll Med, Sch Med Kaohsiung Med Univ, Kaohsiung Municipal Ta Tung Hosp, Dept Neurol Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Neurol I Shou Univ, E Da Hosp, Dept Anesthesiol Chi Mei Med Ctr, Dept Nutr Chi Mei Med Ctr, Dept Anesthesiol Natl Def Med Ctr, Triserv Gen Hosp, Dept Anesthesiol I Shou Univ, E Da Dachang Hosp, Dept Emergency Med I Shou Univ, Coll Med, Sch Med Int Students
Keywords:	Impact Sedation Neuroinflammation Implantation Prevention Depression Strategies Management Survival Outcomes
Date:	2023
Issue Date:	2024-12-25 11:04:08 (UTC+8)
Publisher:	NATURE PORTFOLIO
Abstract:	The aim of this meta-analysis was to assess the association of general anesthesia (GA) exposure with the risk of POD in this patient population. Databases including Medline, EMBASE, Cochrane library, and Google Scholar were searched from inception to December 2022. Analysis of 17 studies published between 2015 and 2021 involving 10,678 individuals revealed an association of GA exposure with an elevated risk of POD [odd ratio (OR) = 1.846, 95% CI 1.329 to 2.563, p = 0.0003, I2 = 68.4%, 10,678 patients]. Subgroup analysis of the diagnostic methods also demonstrated a positive correlation between GA exposure and POD risk when validated methods were used for POD diagnosis (OR = 2.199, 95% CI 1.46 to 3.31, p = 0.0002). Meta-regression analyses showed no significant impact of age, male proportion, and sample size on the correlation between GA and the risk of POD. The reported overall incidence of POD from the included studies regardless of the type of anesthesia was between 0.8 and 27%. Our meta-analysis showed a pooled incidence of 10.3% (95% CI 7% to 15%). This meta-analysis suggested an association of general anesthesia with an elevated risk of postoperative delirium, implying the necessity of implementing appropriate prophylactic strategies against this complication when general anesthesia was used in this clinical setting.
Relation:	Scientific Reports, v.13, n.1, Article 16241
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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