Moderators of the association between attention-deficit/hyperactivity disorder and exposure to anaesthesia and surgery in children
| Autor: | Darrell R. Schroeder, Randall P. Flick, Yu Shi, Hayley J. Dykhoff, David O. Warner, Michael J. Zaccariello, Lindsay R Hunter Guevara, Lindsey R. Sangaralingham |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Patient characteristics Affect (psychology) White People Cohort Studies Risk Factors mental disorders Humans Medicine Attention deficit hyperactivity disorder Anesthesia Child Association (psychology) Retrospective Studies business.industry Incidence Incidence (epidemiology) Racial Groups Hazard ratio medicine.disease Confidence interval Surgery Anesthesiology and Pain Medicine Attention Deficit Disorder with Hyperactivity Child Preschool Surgical Procedures Operative Cohort Female business |
| Zdroj: | British Journal of Anaesthesia. 127:722-728 |
| ISSN: | 0007-0912 |
| DOI: | 10.1016/j.bja.2021.07.025 |
| Popis: | Background Children's exposure to anaesthesia has been associated with risk of developing attention-deficit/hyperactivity disorder (ADHD). The goal of this study was to determine if selected patient characteristics moderate the association between exposure to anaesthesia and ADHD. Methods In a cohort of children born in between 2006 and 2012, exposure to anaesthesia before the age of 5 yr was categorised into unexposed, singly, or multiply exposed. Weighted proportional hazard regression was performed to evaluate the hazard ratios (HRs) of ADHD diagnosis related to anaesthesia exposure. Interaction analyses were performed to evaluate potential moderators. Results Among 185 002 children in the cohort, 9179 were diagnosed with ADHD. Compared with unexposed children, a single exposure to anaesthesia was associated with a HR of 1.39, (95% confidence interval [CI], 1.32–1.47) for ADHD. Multiple exposures were associated with a HR of 1.75 (95% CI, 1.62–1.87). In the analyses evaluating moderators of the association between exposure and ADHD, only the interaction for race was statistically significant (P=0.006); exposure increased the incidence of ADHD to a greater extent in non-White compared with White children. Among children with a single exposure, the age at exposure did not affect the relationship between exposure and incidence of ADHD (P=0.78). Conclusions Exposure of young children to anaesthesia and surgery is associated with an increased incidence of ADHD, with more exposures associated with greater risk. Compared with White children, non-White children are at greater risk for reasons that are unknown but need to be further explored. |
| Databáze: | OpenAIRE |
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