Using a Medicaid database from 2001 – 2018, researchers undertake an observational study that takes advantage of a natural experiment associated with appendicitis to determine whether anesthesia and surgery in childhood were specifically associated with subsequent neurobehavioral outcomes.
134,388 healthy children with appendectomy were identified and the incidence of subsequent externalizing or behavioral disorders, or internalizing or mood or anxiety disorders, was examined and compared to 671,940 matched healthy controls. For comparison, the study also examined 154,887 otherwise healthy children admitted to the hospital for pneumonia, cellulitis, and gastroenteritis, of which only 8% received anesthesia, and compared them to 774,435 matched healthy controls.
Results showed that both children with appendectomy and children with medical admissions were more likely to have the diagnosis of subsequent behavioral and mood or anxiety disorder than matched healthy controls. Although there is an association between neurobehavioral diagnoses and appendectomy, this association is not specific to anesthesia exposure and is stronger in medical admissions. Medical admissions, generally without anesthesia exposure, displayed significantly higher rates of these disorders than appendectomy-exposed patients.
Anesthesiology July 2024