title: Postoperative plasma copeptin levels independently predict delirium and cognitive dysfunction after coronary artery bypass graft surgery.
abstract: Copeptin can reflect individual's stress state and are correlated with poor outcome of critical illness. The occurrence of postoperative delirium (POD) and cognitive dysfunction (POCD) is associated with worse outcome after coronary artery bypass graft (CABG) surgery. The present study aimed to investigate the ability of postoperative plasma copeptin level to predict POD and POCD in patients undergoing CABG surgery. Postoperative plasma copeptin levels of 108 patients were measured by an enzyme-linked immunosorbent assay. It was demonstrated that plasma copeptin levels were substantially higher in patients with POD than without POD (1.8±0.6 ng/mL vs. 1.1±0.3 ng/mL; P<0.001) and in patients with POCD than without POCD (1.9±0.6 ng/mL vs. 1.1±0.4 ng/mL; P<0.001). Plasma copeptin level and age were identified as independent predictors for POD [odds ratio (OR), 67.386; 95% confidence interval (CI), 12.031-377.426; P<0.001 and OR, 1.202; 95% CI, 1.075-1.345; P=0.001] and POCD (OR, 28.814; 95% CI, 7.131-116.425; P<0.001 and OR, 1.151; 95% CI, 1.030-1.285; P=0.003) using a multivariate analysis. For prediction of POD, the area under receiver operating characteristic curve (AUC) of the copeptin concentration (AUC, 0.883; 95% CI, 0.807-0.937) was markedly higher than that of age (AUC, 0.746; 95% CI, 0.653-0.825; P=0.020). For prediction of POCD, the AUC of the copeptin concentration (AUC, 0.870; 95% CI, 0.792-0.927) was markedly higher than that of age (AUC, 0.735; 95% CI, 0.641-0.815; P=0.043). Thus, postoperative plasma copeptin level may be a useful, complementary tool to predict POD and POCD in patients undergoing CABG surgery.
authors: Department of Cardiothoracic Surgery, Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang 157001, China.
authors: Sheng
authors: S
authors: Dong
authors: Department of Anaesthesiology, Clinical Medical School, Mudanjiang Medical College, Mudanjiang, Heilongjiang 157011, China.
authors: Chun-Lai
authors: CL
authors: Li
authors: College of Life Science, Zhejiang Provincial Key Laboratory of Medical Genetics, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.
authors: Wan-Dong
authors: WD
authors: Liang
authors: Department of Neurosurgery, The Centre Hospital of Wenzhou, Wenzhou, Zhejiang 325000, China.
authors: Mao-Hua
authors: MH
authors: Chen
authors: School of Basic Medical Science, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.
authors: Yun-Tian
authors: YT
authors: Bi
authors: Department of Anesthesiology, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China. Electronic address: qingweilv@yeah.net.
authors: Xing-Wang
authors: XW
authors: Li
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D001026:Coronary Artery Bypass; D003693:Delirium / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D006020:Glycopeptides; C048197:copeptins
keywords: Cognitive dysfunction; Copeptin; Coronary artery bypass graft surgery; Delirium; Postoperative