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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study. | Mu et al. Critical Care 2010 14 R238 http ccforum.eom content 14 6 R238 KS CRITICAL CARE RESEARCH Open Access High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery a prospective cohort study 1 1 2 1 1 z- - I 2 2 Dong-Liang Mu Dong-Xin Wang Li-Huan Li Guo-Jin Shan Jun Li Qin-Jun Yu Chun-Xia Shi See related commentary by Kazmierski and Kloszewska http eeforum.eom eontent 15 1 102 Abstract 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 .
