Preoperative Salivary Cortisol AM/PM Ratio Predicts Early Postoperative Cognitive Dysfunction After Noncardiac Surgery in Elderly Patients

Anesthesia and Analgesia
Yuan HanJun-Li Cao

Abstract

The diagnosis of postoperative cognitive dysfunction (POCD) requires complicated neuropsychological testing and is often delayed. Possible biomarkers for early detection or prediction are essential for the prevention and treatment of POCD. Preoperative screening of salivary cortisol levels may help to identify patients at elevated risk for POCD. One hundred twenty patients >60 years of age and undergoing major noncardiac surgery underwent neuropsychological testing 1 day before and 1 week after surgery. Saliva samples were collected in the morning and the evening 1 day before surgery. POCD was defined as a Z-score of ≤-1.96 on at least 2 different tests. The primary outcome was the presence of POCD. The primary objective of this study was to assess the relationship between the ratio of AM (morning) to PM (evening) salivary cortisol levels and the presence of POCD. The secondary objective was to assess the relationship between POCD and salivary cortisol absolute values in the morning or in the evening. POCD was observed in 17.02% (16 of 94; 95% confidence interval [CI], 9.28%-24.76%) of patients 1 week after the operation. A higher preoperative AM/PM salivary cortisol ratio predicted early POCD onset (odds ratio [OR], 1.56; 95% ...Continue Reading

References

Nov 1, 1983·Annals of Clinical Biochemistry·R F ViningK Y Ho
Jan 1, 1994·Psychoneuroendocrinology·C Kirschbaum, D H Hellhammer
Sep 11, 1999·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·E S BrownB S McEwen
Oct 4, 2000·Archives of General Psychiatry·R M Sapolsky
Feb 24, 2001·Acta Anaesthesiologica Scandinavica·L S RasmussenUNKNOWN ISPOCD group. The International Study of Postoperative Cognitive Dysfunction
Jul 9, 2004·The Journal of Clinical Endocrinology and Metabolism·Maria YanevaXavier Bertagna
Sep 9, 2005·Acta Anaesthesiologica Scandinavica·L S RasmussenUNKNOWN ISPOCD2 Investigators
Jul 4, 2007·Archives of General Psychiatry·Brian K LeeBrian S Schwartz
Aug 4, 2009·Psychoneuroendocrinology·Emma K Adam, Meena Kumari
Jul 16, 2010·Acta Anaesthesiologica Scandinavica·L KrenkH Kehlet
Jan 5, 2011·Critical Care : the Official Journal of the Critical Care Forum·Dong-Liang MuChun-Xia Shi
May 1, 2012·Experimental Aging Research·Jennifer L J HeaneyDouglas Carroll
Sep 29, 2012·Psychoneuroendocrinology·Robert C FowkesDerek Renshaw
Nov 28, 2013·Best Practice & Research. Clinical Endocrinology & Metabolism·Ursula Turpeinen, Esa Hämäläinen
Mar 14, 2014·Journal of Neurosurgical Anesthesiology·Qiwu FangJohn P Williams
Sep 11, 2014·British Journal of Anaesthesia·G A MashourM S Avidan
Sep 17, 2014·Anesthesiology·Thomas H OttensUNKNOWN DExamethasone for Cardiac Surgery (DECS) Study Group
Jun 25, 2015·Frontiers in Aging Neuroscience·Ganna AndrosovaReinhard Schneider
Sep 26, 2015·Nature Neuroscience·Bruce S McEwenCarla Nasca
Jul 6, 2016·Neuroscience and Biobehavioral Reviews·Allison E GaffeyMichelle M Wirth
Oct 19, 2016·Nature Reviews. Neuroscience·Laszlo Vutskits, Zhongcong Xie
Nov 5, 2016·Biochemia Medica·Daniela Šupe-DomićIrena Martinović Klarić
Dec 18, 2016·Neurology·Gilda E EnnisScott D Moffat
Mar 4, 2017·Neuroscience and Biobehavioral Reviews·Douglas CarrollSusanne R de Rooij
Jul 18, 2017·Psychoneuroendocrinology·Michaela G CuneoSusan K Lutgendorf

❮ Previous
Next ❯

Citations

Feb 26, 2019·Anesthesia and Analgesia·Yuan HanJun-Li Cao
Oct 28, 2019·Current Opinion in Psychiatry·Lucia Chinnappa-QuinnPerminder S Sachdev
Jan 24, 2020·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak
Dec 8, 2020·Anesthesiology Research and Practice·Kim van SinderenPatrick Schober
May 8, 2021·Current Opinion in Anaesthesiology·Kyung-Cheon Lee, Il-Ok Lee

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.