Preexisting Dementia Is Associated with Increased Risks of Mortality and Morbidity Following Major Surgery: A Nationwide Propensity Score Matching Study

International Journal of Environmental Research and Public Health
Yu-Ming WuYing-Hsuan Tai

Abstract

Patients with dementia are predisposed to multiple physiological abnormalities. It is uncertain if dementia associates with higher rates of perioperative mortality and morbidity. We used reimbursement claims data of Taiwan's National Health Insurance and conducted propensity score matching analyses to evaluate the risk of mortality and major complications in patients with or without dementia undergoing major surgery between 2004 and 2013. We applied multivariable logistic regressions to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for the outcome of interest. After matching to demographic and clinical covariates, 7863 matched pairs were selected for analysis. Dementia was significantly associated with greater risks of 30-day in-hospital mortality (aOR: 1.71, 95% CI: 1.09-2.70), pneumonia (aOR: 1.48, 95% CI: 1.16-1.88), urinary tract infection (aOR: 1.59, 95% CI: 1.30-1.96), and sepsis (OR: 1.77, 95% CI: 1.34-2.34) compared to non-dementia controls. The mortality risk in dementia patients was attenuated but persisted over time, 180 days (aOR: 1.49, 95% CI: 1.23-1.81) and 365 days (aOR: 1.52, 95% CI: 1.30-1.78) after surgery. Additionally, patients with dementia were more likely to receive blood trans...Continue Reading

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Methods Mentioned

BETA
sedation

Software Mentioned

Statistics Analysis System ( SAS )

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