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논문 기본 정보

자료유형
학술저널
저자정보
Song Joo Young (Department of Pediatrics CHA Gangnam Medical Center CHA University School of Medicine Seoul Korea.) Cha Hye Ryeong (Department of Computer Science and Engineering Sungkyunkwan University Suwon Korea.) Lee Seung Won (Department of Precision Medicine Sungkyunkwan University School of Medicine Suwon Korea.) Ha Eun Kyo (Department of Pediatrics Hallym University Kangnam Sacred Heart Hospital Seoul Korea.) Kim Ju Hee (Department of Pediatrics Hallym University Kangdong Sacred Heart Hospital Seoul Korea.) Han Man Yong (Department of Pediatrics CHA Bundang Medical Center CHA University School of Medicine Seongnam Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.38 No.6
발행연도
2023.2
수록면
1 - 15 (15page)
DOI
10.3346/jkms.2023.38.e42

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Background: There are inconsistent reports regarding the association between general anesthesia and adverse neurodevelopmental and behavioral disorders in children. Methods: This nationwide administrative cohort study included children born in Korea between 2008 and 2009, and followed until December 31, 2017. The cohort included 93,717 participants who received general anesthesia with endotracheal intubation (ETI) who were matched to unexposed subjects in a 1:1 ratio. General anesthesia was defined by National Health Insurance Service treatment codes with intratracheal anesthesia, and the index date was the first event of general anesthesia. The primary outcome was attention deficit hyperactive disorder (ADHD), which was defined as at least a principal diagnosis of 10th revision of the International Classification of Diseases code F90.X after the age of 72 months. Neurodevelopment, which was assessed using a developmental screening test (Korean-Ages and Stages Questionnaire [K-ASQ]), was a secondary outcome. The K-ASQ is performed annually from 1 to 6 years of age and consists of 5 domains. The association between general anesthesia and ADHD was estimated using a Cox hazard model, and its association with neurodevelopment was estimated using a generalized estimation equation, with control for multiple risk factors beyond 1 year after the index date. Results: The median age at the index date was 3.8 (95% confidence interval [CI], 1.7–5.8) years, and there were 57,625 (61.5%) men. During a mean follow-up period of 5 years, the incidence rate of ADHD was 42.6 and 27.7 per 10,000 person-years (PY) in the exposed and unexposed groups, respectively (absolute rate difference 14.9 [95% CI, 12.5–17.3] per 10,000 PY). Compared to the unexposed group, the exposed group had an increased risk of ADHD (adjusted hazard ratio, 1.41 [95% CI, 1.30–1.52]). In addition, a longer duration of anesthesia with ETI and more general anesthesia procedures with ETI were associated with greater risk of ADHD. General anesthesia with ETI was also associated with poorer results in the K-ASQ. Conclusion: Administration of general anesthesia with ETI to children is associated with an increased risk of ADHD and poor results in a neurodevelopmental screening test.
#General Anesthesia #Attention Deficit Hyperactive Disorder #Neurodevelopment #Children

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