Incidence of 12-month postoperative cognitive decline following regional vs. general anaesthesia in older patients undergoing hip fracture surgery: follow-up of the RAGA trial

被引：1
|
作者：
Li, Ting [1 ,2 ,3 ]
Li, Jun [1 ,2 ]
Jiang, Chenchen [2 ,3 ]
Yuan, Liyong [4 ]
Wu, Jinze [5 ]
Mazaheri, Ali [6 ,7 ]
Wang, Mingcang [8 ]
Jin, Shengwei [1 ,2 ]
Myles, Paul S. [9 ,10 ]
Yao, Yinguang [11 ]
Wu, Jimin [12 ]
Chen, Junping [13 ]
Smith, Fang G. [2 ,3 ,14 ]
RAGA Study Investigators
机构：
[1] Wenzhou Med Univ, Affiliated Hosp & Yuying Childrens Hosp 2, Dept Anesthesiol & Perioperat Med, Wenzhou, Peoples R China
[2] Wenzhou Med Univ, Yuying Childrens Hosp, Wenzhou, Peoples R China
[3] Wenzhou Med Univ, Affiliated Hosp 2, Clin Res Unit, Wenzhou, Peoples R China
[4] Ningbo 6 Hosp, Dept Ultrason Med, Ningbo, Peoples R China
[5] Wenzhou Med Univ, Affiliated Hosp 1, Dept Anaesthesiol & Perioperat Med, Wenzhou, Peoples R China
[6] Univ Birmingham, Sch Psychol, Birmingham, England
[7] Univ Birmingham, Ctr Human Brain Hlth, Birmingham, England
[8] Taizhou Hosp Zhejiang Prov, Dept Vasc Surg, Taizhou, Peoples R China
[9] Alfred Hosp, Dept Anaesthesiol & Perioperat Med, Melbourne, Australia
[10] Monash Univ, Melbourne, Australia
[11] Lishui Municipal Cent Hosp, Dept Anaesthesiol & Perioperat Med, Lishui, Peoples R China
[12] Lishui Peoples Hosp, Dept Anaesthesiol & Perioperat Med, Lishui, Peoples R China
[13] Univ Chinese Acad Sci, Ningbo 2 Hosp, Ningbo Hosp 2, Dept Radiol, Ningbo, Peoples R China
[14] Univ Birmingham, Coll Med & Hlth, Sch Inflammat Infect & Immun, Birmingham, England
来源：
ANAESTHESIA | 2025年
关键词：
general anaesthesia; hip fracture; neurocognitive function; regional anaesthesia; older patients; MENTAL-STATE-EXAMINATION; DYSFUNCTION; IMPAIRMENT; CHINESE;
D O I：
10.1111/anae.16545
中图分类号：
R614 [麻醉学];
学科分类号：
100217 ;
摘要：
IntroductionData regarding the incidence of 12-month postoperative cognitive decline following regional or general anaesthesia in older patients undergoing hip fracture surgery remain observational. Compared with general anaesthesia, we hypothesised that regional anaesthesia would decrease the incidence of 12-month postoperative cognitive decline.MethodsThis is substudy of a multicentre randomised trial of regional anaesthesia with no sedation vs. general anaesthesia with 12-month follow-up, conducted in nine university hospitals in south-eastern China. Patients aged >= 65 y with hip fractures requiring surgery were eligible for inclusion. The prespecified 1-year primary outcome was the incidence of postoperative cognitive decline at 12 months post-randomisation. Secondary outcomes included major or mild postoperative cognitive decline; changes in Mini-Mental State Examination; newly developed dementia; affective status; and health-related quality of life.ResultsWe recruited 950 patients between October 2014 and September 2018 (n = 474 general and n = 476 regional), with the last participant interviewed in November 2019. A total of 293 patients (139 general vs. 154 regional) were included in the primary analysis of the 12-month outcome. Median (IQR [range]) age of patients was 78 (71-82 [65-96]) y and 217 (74.1%) were female. The incidence of cognitive decline at 12 months was 29.7% vs. 25.4% of patients allocated to general vs. regional anaesthesia, respectively (unadjusted OR 1.2 (95%CI 0.7-2.1), p = 0.43, Bayes factor = 0.28). Major cognitive decline developed in 8.6% vs. 8.5% of patients allocated to general vs. regional anaesthesia, respectively (unadjusted OR 1.0 (95%CI 0.4-2.4)).DiscussionThe incidence of 12-month postoperative cognitive decline was not significantly different in patients having general or regional anaesthesia for hip fracture surgery.
引用
收藏
页数：10
相关论文
共 46 条
  • [31] DURABILITY OF THE THE EFFECTS OF SELF-ADMINISTERED COGNITIVE BEHAVIOR THERAPY FOR PATIENTS WITH MODERATE-TO-SEVERE IRRITABLE BOWEL SYNDROME: 12-MONTH FOLLOW-UP FROM THE IBSOS TRIAL
    Lackner, Jeffrey M.
    Jaccard, James
    Firth, Rebecca S.
    Brenner, Darren M.
    Gudleski, Gregory D.
    Katz, Leonard
    Keefer, Laurie
    Krasner, Susan S.
    Radziwon, Christopher
    Ma, Chang-Xing
    Braun, Abbey C.
    Sitrin, Michael D.
    Hamilton, Frank A.
    GASTROENTEROLOGY, 2018, 154 (06) : S105 - S105
  • [32] Quasi-cluster randomized trial of a six-month low-intensity group-based resistance exercise for hemodialysis patients on depression and cognitive function: a 12-month follow-up
    Nakamura-Taira, Nanako
    Horikawa, Naoshi
    Oka, Fumie
    Igarashi, Yuri
    Kobayashi, Sayaka
    Kato, Shingo
    Enomoto, Takashi
    Kimura, Hitomi
    Watanabe, Yukari
    Kumada, Toru
    Matsuyama, Kimihiko
    Matsuoka, Naoki
    Yoshimasu, Haruo
    HEALTH PSYCHOLOGY AND BEHAVIORAL MEDICINE, 2021, 9 (01): : 741 - 760
  • [33] Protocol for open-label, randomised, controlled trial of intensive surveillance vs. standard postoperative follow-up in patients undergoing surgical resection for oesophageal and gastric cancer (SARONG trial).
    Markar, Sheraz
    Guazzelli, Alice
    Taylor, Amy
    Jones, Laura Lloyd
    Jogarah, Vidoushee
    Cromwell, David
    Landeiro, Filipa
    Maynard, Nick
    Lagergren, Jesper
    Gleeson, Fergus
    Underwood, Tim
    Moss, Alan
    Crosby, Tom David Lewis
    JOURNAL OF CLINICAL ONCOLOGY, 2024, 42 (3_SUPPL) : TPS416 - TPS416
  • [34] Quality of Life and Post-Surgical Complications in Patients on Chronic Antiplatelet Therapy with Proximal Femur Fracture: 12-Month Follow-Up after Implementing a Strategy to Shorten the Time to Surgery
    Merchan-Galvis, Angela
    Anaya, Rafael
    Rodriguez, Mireia
    Llorca, Jordi
    Castejon, Merce
    Gil, Jose Maria
    Millan, Angelica
    Estepa, Veronica
    Cardona, Elena
    Garcia-Sanchez, Yaiza
    Ruiz, Ana
    Martinez-Zapata, Maria Jose
    JOURNAL OF CLINICAL MEDICINE, 2023, 12 (03)
  • [35] 12-Month follow-up of the U-CARE Heart Trial: Using internet-based Cognitive Behavioural Therapy to treat patients experiencing depression and anxiety after myocardial infarction
    Humphries, Sophia Monica
    Wallert, John
    Norlund, Fredrika
    Held, Claes
    Olsson, Erik
    PSYCHOTHERAPY AND PSYCHOSOMATICS, 2019, 88 : 58 - 58
  • [36] Randomized clinical trial on the use of IMAGE1 S LIGHT (SPIES) vs. white light in the prevention of recurrence during transurethral resection of bladder tumors: analysis after 12-month follow-up
    Guzman, C. R. Trelles
    Espinos, E. Linares
    Gonzalez, E. Rios
    Dorrego, J. M. Alonso
    Bazan, A. Aguilera
    Romero, M. E. Jimenez
    Martinez-Pineiro, L.
    ACTAS UROLOGICAS ESPANOLAS, 2024, 48 (07): : 512 - 520
  • [37] Quality of life in patients on chronic antiplatelet therapy with proximal femur fracture: 12-months follow-up after implementing a randomized clinical trial to assess early surgery versus delayed surgery with neuroaxial anaesthesia
    Galvis, Angela Maria Merchan
    Bustillos, Percy-Efrain Pantoja
    Camacho, Rafael Anaya
    Prieto, Mireia Rodriguez
    Billi, Angelica Millan
    Corominas, Francesca Reguant
    Garcia, Jordi Llorca
    Martinez, Merce Castejon
    Sanz, Patricia Guilabert
    Escalona, Maria Mercedes Iborra
    Pardos, Ana Ruiz
    Sanchez, Jose Maria Gil
    Garcia, Maria Victoria Moral
    Zapata, Maria Jose Martinez
    BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY, 2022, 130 : 42 - 43
  • [38] Comparison of combined lumbar and sacral plexus block with sedation versus general anaesthesia on postoperative outcomes in elderly patients undergoing hip fracture surgery (CLSB-HIPELD): study protocol for a prospective, multicentre, randomised controlled trial
    Zhang, Junfeng
    Wang, Xiaofeng
    Zhang, Hui
    Shu, Zhuolin
    Jiang, Wei
    BMJ OPEN, 2019, 9 (03):
  • [39] A Commentary on "The impact of regional versus general anaesthesia on postoperative neurocognitive outcomes in elderly patients undergoing hip fracture surgery: A systematic review and meta-analysis" [Int. J. Surg. 105 (2022) 106854]
    Zhang, Haijun
    Zhao, Zhipeng
    Bai, Dengyan
    Qin, Liyi
    Wang, Enjia
    INTERNATIONAL JOURNAL OF SURGERY, 2022, 107
  • [40] The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up
    Puntumetakul, Rungthip
    Saiklang, Pongsatorn
    Tapanya, Weerasak
    Chatprem, Thiwaphon
    Kanpittaya, Jaturat
    Arayawichanon, Preeda
    Boucaut, Rose
    INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2021, 18 (15)
12345