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DOI 10.1002/alz.13132

Медицинская библиотека · Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023

Outcomes with spinal versus general anesthesia for patients with and without preoperative cognitive impairment: Secondary analysis of a randomized clinical trial.

O'Brien Kyra, Feng Rui, Sieber Frederick, Marcantonio Edward R, Tierney Ann, Magaziner Jay, Carson Jeffrey L, Dillane Derek, Sessler Daniel I, Menio Diane, Ayad Sabry, Stone Trevor, Papp Steven, Schwenk Eric S, Marshall Mitchell, Jaffe J Douglas, Luke Charles, Sharma Balram, Azim Syed, Hymes Robert, Chin Ki-Jinn, Sheppard Richard, Perlman Barry, Sappenfield Joshua, Hauck Ellen, Hoeft Mark A, Karlawish Jason, Mehta Samir, Donegan Derek J, Horan Annamarie, Ellenberg Susan S, Neuman Mark D, REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) Investigators

Рандомизированное исследованиеМногоцентровое исследованиеСтатьяПоддержка исследования: вне правительства СШАPragmatic Clinical TrialПеревод в очереди

Аннотация

INTRODUCTION

The effect of spinal versus general anesthesia on the risk of postoperative delirium or other outcomes for patients with or without cognitive impairment (including dementia) is unknown.

METHODS

Post hoc secondary analysis of a multicenter pragmatic trial comparing spinal versus general anesthesia for adults aged 50 years or older undergoing hip fracture surgery.

RESULTS

Among patients randomized to spinal versus general anesthesia, new or worsened delirium occurred in 100/295 (33.9%) versus 107/283 (37.8%; odds ratio [OR] 0.85; 95% confidence interval [CI] 0.60 to 1.19) among persons with cognitive impairment and 70/432 (16.2%) versus 71/445 (16.0%) among persons without cognitive impairment (OR 1.02; 95% CI 0.71 to 1.47, p = 0.46 for interaction). Delirium severity, in-hospital complications, and 60-day functional recovery did not differ by anesthesia type in patients with or without cognitive impairment.

DISCUSSION: Anesthesia type is not associated with differences in delirium and functional outcomes among persons with or without cognitive impairment.

Для цитирования: O'Brien Kyra, Feng Rui, Sieber Frederick, Marcantonio Edward R, Tierney Ann, Magaziner Jay, Carson Jeffrey L, Dillane Derek, Sessler Daniel I, Menio Diane, Ayad Sabry, Stone Trevor, Papp Steven, Schwenk Eric S, Marshall Mitchell, Jaffe J Douglas, Luke Charles, Sharma Balram, Azim Syed, Hymes Robert, Chin Ki-Jinn, Sheppard Richard, Perlman Barry, Sappenfield Joshua, Hauck Ellen, Hoeft Mark A, Karlawish Jason, Mehta Samir, Donegan Derek J, Horan Annamarie, Ellenberg Susan S, Neuman Mark D, REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) Investigators. Outcomes with spinal versus general anesthesia for patients with and without preoperative cognitive impairment: Secondary analysis of a randomized clinical trial.. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2023. DOI: 10.1002/alz.13132.

Предметные рубрики MeSH

HumansDeliriumPostoperative ComplicationsCognitive DysfunctionAnesthesia, GeneralHip Fractures
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