Relationship between Surgery under General Anesthesia and the Development of Dementia: A Systematic Review and Meta-Analysis
Table 3
Summary estimates, heterogeneity, and publication bias for meta-analyses of overall studies and subgroups.
Characteristics
Summary estimates
Heterogeneity
Publication bias
Trim and fill
No. of studies
Pooled ES (95% CI)
95% PI
(%)
Coef (95% CI)
Pooled ES (95% CI)
Total
23
1.11 (1.06–1.15)
0.98-1.21
<0.001
79.4
0.096
-0.91 (-1.99–0.24)
1.09 (0.94–1.27)
Design
Cohort
6
1.11 (1.06–1.16)
0.93-1.27
<0.001
88.5
Case-control
17
1.15 (1.03–1.17)
0.81-1.20
<0.001
74.8
0.088
-1.02 (-2.22–0.17)
1.07 (0.87–1.32)
Region
America
10
0.83 (0.72–0.94)
0.48-1.1
0.354
9.6
0.626
0.49 (-1.73–2.71)
Australia
1
0.95 (0.50–1.81)
Asia
5
1.23 (1.17–1.28)
0.98-1.41
<0.001
87.5
Europe
7
0.96 (0.88–1.05)
0.68-1.22
0.055
51.3
Exposure assessment
Medical record
12
1.15 (1.10–1.19)
1.01-1.25
<0.001
84.1
0.442
-0.89 (-3.38–1.59)
Self or surrogate-reported
11
0.73 (0.59–0.87)
0.28-1.08
0.777
0.0
0.155
1.11 (-0.51–2.72)
Dementia definition
Alzheimer’s disease
17
0.86 (0.76–0.95)
0.58-1.07
0.703
0.0
0.260
0.72 (-0.60–2.04)
Dementia
6
1.18 (1.13–1.23)
0.99-1.28
<0.001
90.6
Case ascertainment
Standard criteriaa
13
0.82 (0.72–0.92)
0.73-1.07
0.478
0.0
0.147
1.09 (-0.45–2.63)
Clinical diagnosis
10
1.18 (1.13–1.23)
1.08-1.39
<0.001
81.2
0.493
-0.75 (-3.17–1.67)
Abbreviations. Pooled ES: pooled estimates; PI: prediction interval; Coef: coefficient. aStandard criteria represent the diagnosis for Alzheimer’s disease or dementia using object criteria or algorithm such as Diagnostic and Statistical Manual of Mental Disorders (DSM), National Institutes of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders (NINCDS-ADRDA), and Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) algorithm.
