IR@PKUHSC  > 北京大学第一临床医学院
学科主题临床医学
High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study
Mu, Dong-Liang1; Wang, Dong-Xin1; Li, Li-Huan2,3,4; Shan, Guo-Jin1; Li, Jun1; Yu, Qin-Jun2,3,4; Shi, Chun-Xia2,3,4
刊名CRITICAL CARE
2010
DOI10.1186/cc9393
14期:6
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Critical Care Medicine
研究领域[WOS]General & Internal Medicine
关键词[WOS]INTENSIVE-CARE-UNIT ; MECHANICALLY VENTILATED PATIENTS ; CONFUSION ASSESSMENT METHOD ; CRITICALLY-ILL PATIENTS ; AGITATION-SEDATION SCALE ; QUALITY-OF-LIFE ; POSTOPERATIVE DELIRIUM ; CARDIAC-SURGERY ; DIABETES-MELLITUS ; CARDIOPULMONARY BYPASS
英文摘要

Introduction: The pathophysiology of postoperative delirium remains poorly understood. The purpose of this study was to examine the relationship between serum cortisol level and occurrence of early postoperative delirium in patients undergoing coronary artery bypass graft (CABG) surgery.

Methods: A total of 243 patients undergoing elective CABG surgery were enrolled. Patients were examined twice daily during the first five postoperative days and postoperative delirium was diagnosed by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Blood samples were obtained between 7 a. m. and 8 a. m. on the first postoperative day and serum cortisol concentrations were then measured. Multivariate logistic regression analyses were performed to identify risk factors of postoperative delirium.

Results: Postoperative delirium occurred in 50.6% (123 of 243) of patients. High serum cortisol level was significantly associated with increased risk of postoperative delirium (OR 3.091, 95% CI 1.763-5.418, P < 0.001). Other independent risk factors of postoperative delirium included increasing age (OR 1.111, 95% CI 1.065-1.159, P < 0.001), history of diabetes mellitus (OR 1.905, 95% CI 1.001-3.622, P = 0.049), prolonged duration of surgery (OR 1.360, 95% CI 1.010-1.831, P = 0.043), and occurrence of complications within the first day after surgery (OR 2.485, 95% CI 1.184-5.214, P = 0.016). Patients who developed postoperative delirium had a higher incidence of postoperative complications and a prolonged duration of postoperative ICU and hospital stay.

Conclusions: Delirium was a common complication after CABG surgery. High serum cortisol level was associated with increased risk of postoperative delirium. Patients who developed delirium had outcomes worse than those who did not.

语种英语
WOS记录号WOS:000287516100044
引用统计
被引频次:50[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55798
专题北京大学第一临床医学院
作者单位1.Peking Univ, Hosp 1, Dept Anesthesiol & Surg Intens Care, Beijing 100034, Peoples R China
2.Chinese Acad Med Sci, Cardiovasc Inst, Dept Anesthesiol, Beijing 100037, Peoples R China
3.Chinese Acad Med Sci, Fuwai Hosp, Beijing 100037, Peoples R China
4.Peking Union Med Coll, Beijing 100037, Peoples R China
推荐引用方式
GB/T 7714
Mu, Dong-Liang,Wang, Dong-Xin,Li, Li-Huan,et al. High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study[J]. CRITICAL CARE,2010,14(6).
APA Mu, Dong-Liang.,Wang, Dong-Xin.,Li, Li-Huan.,Shan, Guo-Jin.,Li, Jun.,...&Shi, Chun-Xia.(2010).High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study.CRITICAL CARE,14(6).
MLA Mu, Dong-Liang,et al."High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study".CRITICAL CARE 14.6(2010).
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