| Academic performance in adolescence after inguinal hernia repair in infancy: a nationwide cohort study. | |
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MedLine Citation:
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PMID: 21368654 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although animal studies have indicated that general anesthetics may result in widespread apoptotic neurodegeneration and neurocognitive impairment in the developing brain, results from human studies are scarce. We investigated the association between exposure to surgery and anesthesia for inguinal hernia repair in infancy and subsequent academic performance. METHODS: Using Danish birth cohorts from 1986-1990, we compared the academic performance of all children who had undergone inguinal hernia repair in infancy to a randomly selected, age-matched 5% population sample. Primary analysis compared average test scores at ninth grade adjusting for sex, birth weight, and paternal and maternal age and education. Secondary analysis compared the proportions of children not attaining test scores between the two groups. RESULTS: From 1986-1990 in Denmark, 2,689 children underwent inguinal hernia repair in infancy. A randomly selected, age-matched 5% population sample consists of 14,575 individuals. Although the exposure group performed worse than the control group (average score 0.26 lower; 95% CI, 0.21-0.31), after adjusting for known confounders, no statistically significant difference (-0.04; 95% CI, -0.09 to 0.01) between the exposure and control groups could be demonstrated. However, the odds ratio for test score nonattainment associated with inguinal hernia repair was 1.18 (95% CI, 1.04-1.35). Excluding from analyses children with other congenital malformations, the difference in mean test scores remained nearly unchanged (0.05; 95% CI, 0.00-0.11). In addition, the increased proportion of test score nonattainment within the exposure group was attenuated (odds ratio = 1.13; 95% CI, 0.98-1.31). CONCLUSION: In the ethnically and socioeconomically homogeneous Danish population, we found no evidence that a single, relatively brief anesthetic exposure in connection with hernia repair in infancy reduced academic performance at age 15 or 16 yr after adjusting for known confounding factors. However, the higher test score nonattainment rate among the hernia group could suggest that a subgroup of these children are developmentally disadvantaged compared with the background population. |
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Authors:
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Tom G Hansen; Jacob K Pedersen; Steen W Henneberg; Dorthe A Pedersen; Jeffrey C Murray; Neil S Morton; Kaare Christensen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Anesthesiology Volume: 114 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-05-02 Completed Date: 2011-07-18 Revised Date: 2012-01-03 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 1076-85 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia and Intensive Care, Odense University Hospital, Denmark. tomghansen@dadlnet.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Achievement Adolescent Anesthesia / adverse effects, statistics & numerical data* Causality Cognition Disorders / epidemiology, etiology Cohort Studies Comorbidity Denmark / epidemiology Educational Status* Female Hernia, Inguinal / surgery* Humans Infant Infant, Newborn Male Odds Ratio Surgical Procedures, Operative / adverse effects, statistics & numerical data* |
| Comments/Corrections | |
Comment In:
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Anesthesiology. 2011 Dec;115(6):1387; author reply 1387-8
[PMID:
22108309
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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