Table 3:
Association between post-enrollment regional anesthesia and post-enrollment general anesthesia with cognitive scores over time*
| Regional Anesthesia | General Anesthesia | |||||
|---|---|---|---|---|---|---|
| Scale | Slope est‡ |
Difference in slope est. (95% CI) |
P | Difference in slope est. (95% CI) |
P | Regional vs. General P† |
| Primary analysis | ||||||
| Global z score | −0.071 | −0.041 (−0.072 to −0.010) | .011 | −0.061 (−0.078 to −0.044) | <.001 | .252 |
| Memory domain | −0.014 | −0.011 (−0.050 to 0.028) | .565 | −0.065 (−0.084 to −0.045) | <.001 | .011 |
| Language domain | −0.077 | −0.004 (−0.038 to 0.030) | .828 | −0.014 (−0.030 to 0.003) | .099 | .566 |
| Visuospatial domain | −0.041 | −0.013 (−0.045 to 0.020) | .445 | −0.006 (−0.021 to 0.008) | .387 | .709 |
| Attention/executive domain | −0.092 | −0.036 (−0.071 to −0.001) | .044 | −0.052 (−0.072 to −0.033) | <.001 | .394 |
| Sensitivity analysis - orthopedic surgeries only | ||||||
| Global z score | −0.072 | −0.033 (−0.065 to 0.000) | .052 | −0.052 (−0.091 to −0.014) | .008 | .430 |
| Memory domain | −0.014 | −0.011 (−0.052 to 0.031) | .620 | −0.071 (−0.111 to −0.031) | <.001 | .035 |
| Language domain | −0.078 | 0.005 (−0.032 to 0.042) | .784 | 0.000 (−0.035 to 0.034) | .982 | .823 |
| Visuospatial domain | −0.041 | −0.015 (−0.049 to 0.018) | .360 | −0.016 (−0.051 to 0.019) | .366 | .981 |
| Attention/executive domain | −0.091 | −0.030 (−0.067 to 0.007) | .111 | −0.038 (−0.082 to 0.005) | .080 | .756 |
Analyses presented are from adjusted mixed effects models with N=1,813 subjects with complete covariate data. All models are adjusted for prior 20-year exposure to general and regional anesthesia, age, sex, cognitive status at enrollment, education, marital status, Charlson comorbidity index, presence of APOE-ε4 genotype, ever-diagnosed alcohol problem, smoking status, midlife diagnosis of diabetes, hypertension, and dyslipidemia, and history of atrial fibrillation, congestive heart failure, stroke, and coronary artery disease. Estimates and confidence limits are for average slope (change in outcome over time) and change in slope after new exposure to regional or general anesthesia. Patients were censored at the date of z-score prior to occurrence of the second type of new anesthesia following first z-score.
P-value for comparison between regional and general anesthesia.
Slope estimate corresponds to the average slope following enrollment prior to a post-enrollment exposure to regional or general anesthesia.