SEARCHMETA-ANALYSIScardiology, surgery

meta-analysis·cardiology, surgery, geriatrics, systematic review, meta-analysis·PMC10533830

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

Scientific Reports · 9 authors, 12 centres

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TL;DR

This meta-analysis of 17 studies found that general anesthesia exposure was associated with a significantly higher risk of postoperative delirium in patients undergoing transcatheter aortic valve replacement.

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This systematic review and meta-analysis pooled data from 17 observational studies involving 10,678 patients to assess the association between general anesthesia (GA) and postoperative delirium (POD) after transcatheter aortic valve replacement (TAVR). The primary outcome showed GA exposure was associated with a significantly increased risk of POD (OR 1.846, 95% CI 1.329 to 2.563). Subgroup analysis confirmed this association when validated POD diagnostic methods were used (OR 2.199, 95% CI 1.46 to 3.31). Meta-regression found no significant impact of age, male proportion, or sample size on the GA-POD link. The pooled incidence of POD across studies was 10.3%. Limitations include the predominance of observational studies and potential unmeasured confounding. The findings suggest an association but do not establish causation, warranting further randomized trials to confirm the relationship and test preventive strategies.

STUDY TYPE

meta-analysis

SPECIALTY

cardiology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10533830

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

Scientific Reports

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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, I 2 = 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.

CITATION EXPORT

Ching-Chung Ko, Kuo-Chuan Hung, Yang-Pei Chang et al.. Association of general anesthesia exposure with risk of postoperative delirium in patients receiving transcatheter aortic valve replacement: a meta-analysis and systematic review. Scientific Reports. (2023). https://doi.org/10.1038/s41598-023-43548-2

AUTHORS

9 · 12 CENTRES

Ching-Chung Ko, Kuo-Chuan Hung, Yang-Pei Chang, Chien-Cheng Liu, Wan-Jung Cheng, Jheng-Yan Wu, Yu-Yu Li, Tso-Chou Lin, Cheuk-Kwan Sun

1https://ror.org/02y2htg06grid.413876.f0000 0004 0572 9255Department of Medical Imaging, Chi Mei Medical Center, Tainan City, Taiwan
2https://ror.org/02834m470grid.411315.30000 0004 0634 2255Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan
3https://ror.org/02y2htg06grid.413876.f0000 0004 0572 9255Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
4https://ror.org/00mjawt10grid.412036.20000 0004 0531 9758School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung City, Taiwan
5grid.412019.f0000 0000 9476 5696Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
6grid.412019.f0000 0000 9476 5696Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
7grid.411447.30000 0004 0637 1806Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
8https://ror.org/02y2htg06grid.413876.f0000 0004 0572 9255Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan
9https://ror.org/02y2htg06grid.413876.f0000 0004 0572 9255Department of Anesthesiology, Chi Mei Medical Center, Chiali, Tainan City, Taiwan
10grid.260565.20000 0004 0634 0356Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
11https://ror.org/04d7e4m76grid.411447.30000 0004 0637 1806Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, No. 305, Dachang 1St Road, Sanmin District, Kaohsiung City, Taiwan
12https://ror.org/04d7e4m76grid.411447.30000 0004 0637 1806School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan