TABLE 4.
Association of Anesthetic Exposure Before the Age of 2 Years With Group-Administered Ability and Achievement Test Scores (TOC and CAT)a
| No. of Exposures | No Covariate Adjustment |
ASA-PS Adjusted |
ADG Adjusted |
|||
|---|---|---|---|---|---|---|
| Parameter Estimate (95% CI) | P | Parameter Estimate (95% CI) | P | Parameter Estimate (95% CI) | P | |
| Total cognitive score | .032 | .180 | .105 | |||
| 0 (n = 529) | Referent | Referent | Referent | |||
| 1 (n = 200) | −0.05 (−0.21 to 0.12) | −0.04 (−0.21 to 0.12) | −0.04 (−0.21 to 0.13) | |||
| ≥2 (n = 40) | −0.44 (−0.76 to −0.11) | −0.33 (−0.68 to 0.02) | −0.38 (−0.72 to −0.03) | |||
| Memory subscale score | .049 | .124 | .083 | |||
| 0 (n = 526) | Referent | Referent | Referent | |||
| 1 (n = 200) | −0.04 (−0.20 to 0.13) | −0.03 (−0.20 to 0.13) | −0.04 (−0.21 to 0.13) | |||
| ≥2 (n = 40) | −0.41 (−0.73 to −0.08) | −0.37 (−0.72 to −0.01) | −0.39 (−0.74 to −0.05) | |||
| Mathematics total score | .016 | .087 | .023 | |||
| 0 (n = 638) | Referent | Referent | Referent | |||
| 1 (n = 244) | 0.05 (−0.09 to 0.19) | 0.06 (−0.08 to 0.20) | 0.06 (−0.09 to 0.21) | |||
| ≥2 (N = 54) | −0.35 (−0.62 to −0.09) | −0.27 (−0.55 to 0.01) | −0.34 (−0.62 to −0.06) | |||
| Reading total score | .255 | .406 | .290 | |||
| 0 (n = 646) | Referent | Referent | Referent | |||
| 1 (n = 247) | 0.01 (−0.12 to 0.14) | 0.01 (−0.12 to 0.14) | 0.01 (−0.13 to 0.14) | |||
| ≥2 (n = 55) | −0.20 (−0.44 to 0.04) | −0.17 (−0.42 to 0.09) | −0.19 (−0.45 to 0.06) | |||
| Phonics subscale score | .789 | .946 | .754 | |||
| 0 (n = 613) | Referent | Referent | Referent | |||
| 1 (n = 232) | 0.02 (−0.12 to 0.15) | 0.02 (−0.12 to 0.16) | 0.05 (−0.10 to 0.19) | |||
| ≥2 (n = 52) | −0.08 (−0.34 to 0.18) | −0.01 (−0.28 to 0.26) | −0.04 (−0.31 to 0.24) | |||
| Written language total score | .189 | .481 | .302 | |||
| 0 (n = 627) | Referent | Referent | Referent | |||
| 1 (n = 242) | 0.02 (−0.11 to 0.15) | 0.03 (−0.11 to 0.16) | 0.04 (−0.10 to 0.18) | |||
| ≥2 (n = 54) | −0.22 (−0.46 to 0.03) | −0.14 (−0.40 to 0.12) | −0.17 (−0.43 to 0.09) | |||
| Spelling subscale score | .425 | .526 | .299 | |||
| 0 (n = 624) | Referent | Referent | Referent | |||
| 1 (n = 238) | 0.04 (−0.10 to 0.18) | 0.04 (−0.10 to 0.18) | 0.04 (−0.11 to 0.18) | |||
| ≥2 (n = 53) | −0.15 (−0.41 to 0.12) | −0.12 (−0.40 to 0.16) | −0.19 (−0.47 to 0.09) | |||
Results from the last available test were used for each scale. For the 7 scores included, the median age at the time of the last available test ranged from 11.4 to 12.7 years and did not differ significantly between those exposed to anesthesia versus not.
a
National percentile scores were transformed to z scores by using a probit transformation and analyzed using a mixed linear model. Three models were fit for each scale: the first model did not adjust for any covariates; the second model included ASA-PS as a covariate; and the third model included ADG morbidity clusters as covariates.