| Title: | Association between anesthetic-surgical exposure and epilepsy risk in middle-aged and elderly populations: a UK Biobank-based analysis |
| Journal: | Chinese Journal of Neuromedicine |
| Published: | 15 Feb 2026 |
| DOI: | https://doi.org/10.3760/cma.j.cn115354-20251030-00675 |
Publication 20849
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Abstract
Objective To explore the association between anesthetic-surgical exposure and epilepsy risk in middle-aged and elderly populations. Methods A total of 495,310 subjects recruited through 22 assessment centers of the UK Biobank from January 2006 to December 2010 were selected as study subjects. According to self-reported frequency of previous anesthetic-surgical exposures, these subjects were divided into a non-anesthetic-surgical exposure group ( n =109,236) and an anesthetic-surgical exposure group ( n =386,074); subjects in the anesthetic-surgical exposure group were further divided into a 1-time anesthetic-surgical exposure group ( n =150,077), a 2-time anesthetic-surgical exposure group ( n =111,911), and a ≥3-time anesthetic-surgical exposure group ( n =124,086). Based on the follow-up data from January 1, 2011 to April 30, 2024, epilepsy occurrence was determined. Differences in baseline data between the non-anesthetic-surgical exposure group and anesthetic-surgical exposure group were compared. Kaplan-Meier survival analysis was used to compare the differences in cumulative incidence of epilepsy among groups. Multivariate Cox proportional hazards regression was used to analyze the associations of frequency of anesthetic-surgical exposures (0, 1-time, 2-time and ≥3-time) with epilepsy risk. Subgroup analysis was conducted to explore the associations of frequency of anesthetic-surgical exposures with epilepsy risk in subjects with different characteristics and investigate whether potential interactions exist. Results During the follow-up period, 3,227 subjects were diagnosed as having epilepsy, and 492,083 subjects were diagnosed as not having epilepsy. Significant differences in age, sex and race were noted between the non-anesthetic-surgical exposure group and anesthetic-surgical exposure group (all P <0.05). Kaplan-Meier survival analysis showed that the cumulative incidence of epilepsy in the anesthetic-surgical exposure group was significantly higher than that in the non-anesthetic-surgical exposure group ( χ 2 =66.605, P <0.001). Multivariate Cox proportional hazards regression analysis showed that anesthetic-surgical exposure was significantly associated with increased epilepsy risk ( HR =1.327, 95% CI : 1.194-1.456, P <0.001). Kaplan-Meier survival analysis also showed significant differences in cumulative incidence of epilepsy among the 1-time anesthetic-surgical exposure group, 2-time anesthetic-surgical exposure group, and ≥3-time anesthetic-surgical exposure group ( χ 2 =120.089, P <0.001), and the cumulative incidence of epilepsy gradually increased with increasing frequency of anesthetic-surgical exposures ( P <0.05). Multivariate Cox proportional hazards regression analysis showed that compared with the non-anesthetic-surgical exposure group, the epilepsy risk was significantly increased in the 1-time anesthetic-surgical exposure group ( HR =1.204, 95% CI : 1.072-1.352, P <0.001), the 2-time anesthetic-surgical exposure group ( HR =1.290, 95% CI : 1.143-1.456, P <0.001), and the ≥3-time anesthetic-surgical exposure group ( HR =1.493, 95% CI : 1.327-1.679, P <0.001), and the epilepsy risk increased with increasing frequency of anesthetic-surgical exposures (trend test: P <0.001). Interaction analysis showed that anesthetic-surgical exposure was significantly associated with the epilepsy risk in the middle-aged population (45≤age<65 years, HR =1.499, 95% CI : 1.344-1.672, P <0.001), but not significantly associated with epilepsy risk in the elderly population (≥65 years old, HR =1.131, 95% CI : 0.941-1.359, P =0.190). Conclusion Anesthetic-surgical exposure significantly increases epilepsy risk in middle-aged and elderly adults, with a higher risk being associated with more frequent exposures; the association is more significant in the middle-aged population.</p>
7 Authors
- 程序
- 杨皓钧
- 尹曾珍
- 陈潮金
- 侯新冉
- 王锷
- 宋宗斌
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