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学科主题: 临床医学
题名:
High Postoperative Serum Cortisol Level Is Associated with Increased Risk of Cognitive Dysfunction Early after Coronary Artery Bypass Graft Surgery: A Prospective Cohort Study
作者: Mu, Dong-Liang1; Li, Li-Huan2,3; Wang, Dong-Xin1; Li, Nan1; Shan, Guo-Jin1; Li, Jun1; Yu, Qin-Jun2,3; Shi, Chun-Xia2,3
刊名: PLOS ONE
发表日期: 2013-10-15
DOI: 10.1371/journal.pone.0077637
卷: 8, 期:10
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Multidisciplinary Sciences
研究领域[WOS]: Science & Technology - Other Topics
关键词[WOS]: RANDOMIZED CONTROLLED-TRIAL ; CARDIAC-SURGERY ; CARDIOPULMONARY BYPASS ; OLDER-ADULTS ; HEART-FAILURE ; STRESS ; IMPAIRMENT ; ANESTHESIA ; DELIRIUM ; IMPACT
英文摘要:

Context: Stress response induced by surgery is proposed to play an important role in the pathogenesis of postoperative cognitive dysfunction.

Objective: To investigate the association between postoperative serum cortisol level and occurrence of cognitive dysfunction early after coronary artery bypass graft surgery.

Design: Prospective cohort study.

Setting: Two teaching hospitals.

Patients: One hundred and sixth-six adult patients who were referred to elective coronary artery bypass graft surgery from March 2008 to December 2009.

Intervention: None.

Main Outcome Measures: Neuropsychological tests were completed one day before and seven days after surgery. Cognitive dysfunction was defined using the same definition as used in the ISPOCD1-study. Blood samples were obtained in the first postoperative morning for measurement of serum cortisol concentration. Multivariate Logistic regression analyses were performed to assess the relationship between serum cortisol level and occurrence of postoperative cognitive dysfunction.

Results: Cognitive dysfunction occurred in 39.8% (66 of 166) of patients seven days after surgery. Multivariate Logistic regression analysis showed that high serum cortisol level was significantly associated with the occurrence of postoperative cognitive dysfunction (odds ratio [OR] 2.603, 95% confidence interval [CI] 1.371-4.944, P = 0.003). Other independent predictors of early postoperative cognitive dysfunction included high preoperative New York Heart Association functional class (OR 0.402, 95% CI 0.207-0.782, P = 0.007), poor preoperative Grooved Pegboard test score of nondominant hand (OR 1.022, 95% CI 1.003-1.040, P = 0.020), use of penehyclidine as premedication (OR 2.565, 95% CI 1.109-5.933, P = 0.028), and occurrence of complications within seven days after surgery (OR 2.677, 95% CI 1.201-5.963, P = 0.016).

Conclusions: High serum cortisol level in the first postoperative morning was associated with increased risk of cognitive dysfunction seven days after coronary artery bypass graft surgery.

语种: 英语
项目资助者: Peking University First Hospital, Beijing, China
WOS记录号: WOS:000325894100087
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/58745
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Dept Anesthesiol & Surg Intens Care, Beijing 100871, Peoples R China
2.Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Fuwai Hosp, Dept Anesthesiol,State Key Lab Cardiovasc Dis, Beijing 100730, Peoples R China
3.Peking Union Med Coll, Beijing 100021, Peoples R China

Recommended Citation:
Mu, Dong-Liang,Li, Li-Huan,Wang, Dong-Xin,et al. High Postoperative Serum Cortisol Level Is Associated with Increased Risk of Cognitive Dysfunction Early after Coronary Artery Bypass Graft Surgery: A Prospective Cohort Study[J]. PLOS ONE,2013,8(10).
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