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High Postoperative Serum Cortisol Level Is Associated with Increased Risk of Cognitive Dysfunction Early after Coronary Artery Bypass Graft Surgery: A Prospective Cohort Study
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
2013-10-15
DOI10.1371/journal.pone.0077637
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
WOS记录号WOS:000325894100087
资助机构Peking University First Hospital, Beijing, China
引用统计
被引频次:13[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/400002259/58745
专题北京大学第一临床医学院
北京大学第一临床医学院_麻醉科
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
推荐引用方式
GB/T 7714
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).
APA Mu, Dong-Liang.,Li, Li-Huan.,Wang, Dong-Xin.,Li, Nan.,Shan, Guo-Jin.,...&Shi, Chun-Xia.(2013).High Postoperative Serum Cortisol Level Is Associated with Increased Risk of Cognitive Dysfunction Early after Coronary Artery Bypass Graft Surgery: A Prospective Cohort Study.PLOS ONE,8(10).
MLA Mu, Dong-Liang,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".PLOS ONE 8.10(2013).
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