Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients
Abstract Background We assessed the relationships between levels of preoperative thyroid hormone (TH), cortisol, interleukin-2 (IL-2), and procalcitonin (PCT) and postoperative delirium (POD) in acute type A aortic dissection (ATAAD) patients receiving modified triple-branched stent-graft (MTBSG) im...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02962-6 |
| _version_ | 1811211919277686784 |
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| author | Guo-Zhong Zheng Xing-Feng Chen Liang-Wan Chen Zeng-Rong Luo |
| author_facet | Guo-Zhong Zheng Xing-Feng Chen Liang-Wan Chen Zeng-Rong Luo |
| author_sort | Guo-Zhong Zheng |
| collection | DOAJ |
| description | Abstract Background We assessed the relationships between levels of preoperative thyroid hormone (TH), cortisol, interleukin-2 (IL-2), and procalcitonin (PCT) and postoperative delirium (POD) in acute type A aortic dissection (ATAAD) patients receiving modified triple-branched stent-graft (MTBSG) implant surgeries. Methods ATAAD patients received MTBSG implant surgeries in our hospital between February 2019 and December 2020 were recruited. We separated them into a POD and non-POD cohort and employed univariable and multivariable regression analysis to establish independent correlations between preoperative THs, cortisol, IL-2, and PCT and POD. In addition, we conducted stratification analyses to examine the link between pre-surgical THs and POD in normal TSH and lower TSH subgroups. Results POD occurred in 78 of 224 patients (34.8%). POD patients exhibited markedly reduced preoperative free triiodothyronine (FT3) (P = 0.008) and free thyroxine (FT4) (P = 0.023) levels, while remarkably enhanced preoperative cortisol (P < 0.001), IL-2 (P < 0.001), and PCT (P < 0.001) levels. Based on multivariate regression analysis, reduced preoperative FT3 (P = 0.032), as well as augmented preoperative IL-2 (P = 0.001), cortisol (P < 0.001), and PCT (P = 0.016) were strong stand-alone risk factors for POD. Moreover, subgroup analysis found the association between FT3 (P = 0.029), FT4 (P = 0.042) and POD was both significant in patients with normal TSH levels. Conclusions Reduced preoperative FT3 and elevated preoperative cortisol, IL-2, and PCT were strong indicators of POD in ATAAD patients. Hence, we recommend that the thyroid function, cortisol, PCT, and IL-2 should be evaluated prior to surgery in ATAAD patients. |
| first_indexed | 2024-04-12T05:21:27Z |
| format | Article |
| id | doaj.art-97ed67c754074a31bf4692b855de645b |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-12T05:21:27Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-97ed67c754074a31bf4692b855de645b2022-12-22T03:46:28ZengBMCBMC Cardiovascular Disorders1471-22612022-11-0122111010.1186/s12872-022-02962-6Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patientsGuo-Zhong Zheng0Xing-Feng Chen1Liang-Wan Chen2Zeng-Rong Luo3Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityDepartment of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityDepartment of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityDepartment of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical UniversityAbstract Background We assessed the relationships between levels of preoperative thyroid hormone (TH), cortisol, interleukin-2 (IL-2), and procalcitonin (PCT) and postoperative delirium (POD) in acute type A aortic dissection (ATAAD) patients receiving modified triple-branched stent-graft (MTBSG) implant surgeries. Methods ATAAD patients received MTBSG implant surgeries in our hospital between February 2019 and December 2020 were recruited. We separated them into a POD and non-POD cohort and employed univariable and multivariable regression analysis to establish independent correlations between preoperative THs, cortisol, IL-2, and PCT and POD. In addition, we conducted stratification analyses to examine the link between pre-surgical THs and POD in normal TSH and lower TSH subgroups. Results POD occurred in 78 of 224 patients (34.8%). POD patients exhibited markedly reduced preoperative free triiodothyronine (FT3) (P = 0.008) and free thyroxine (FT4) (P = 0.023) levels, while remarkably enhanced preoperative cortisol (P < 0.001), IL-2 (P < 0.001), and PCT (P < 0.001) levels. Based on multivariate regression analysis, reduced preoperative FT3 (P = 0.032), as well as augmented preoperative IL-2 (P = 0.001), cortisol (P < 0.001), and PCT (P = 0.016) were strong stand-alone risk factors for POD. Moreover, subgroup analysis found the association between FT3 (P = 0.029), FT4 (P = 0.042) and POD was both significant in patients with normal TSH levels. Conclusions Reduced preoperative FT3 and elevated preoperative cortisol, IL-2, and PCT were strong indicators of POD in ATAAD patients. Hence, we recommend that the thyroid function, cortisol, PCT, and IL-2 should be evaluated prior to surgery in ATAAD patients.https://doi.org/10.1186/s12872-022-02962-6Thyroid hormonesCortisolPostoperative deliriumIL-2Aortic dissection |
| spellingShingle | Guo-Zhong Zheng Xing-Feng Chen Liang-Wan Chen Zeng-Rong Luo Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients BMC Cardiovascular Disorders Thyroid hormones Cortisol Postoperative delirium IL-2 Aortic dissection |
| title | Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients |
| title_full | Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients |
| title_fullStr | Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients |
| title_full_unstemmed | Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients |
| title_short | Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients |
| title_sort | thyroid hormone cortisol interleukin 2 and procalcitonin regulate postoperative delirium in acute type a aortic dissection patients |
| topic | Thyroid hormones Cortisol Postoperative delirium IL-2 Aortic dissection |
| url | https://doi.org/10.1186/s12872-022-02962-6 |
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