The Related Risk Factors Of Early Postoperative Cognitive Dysfunction In Cardiac Valve Surgery

Objective:Postoperative cognitive dysfunction(POCD)is a common complication of cardiac surgery,which seriously affect the prognosis of patients.This study aimed to explore risk factors for early POCD in patients undergoing cardiac valve surgery and the correlation between early POCD and serum S100 B protein level.Methods:Eighty patients underwent mitral valve replacement concomitant with tricuspid annuloplasty from June 2015 to August 2016 in the first affiliated hospital of nanchang university was studied.Patients was proceed neuropsychological tests at 1day before and 5 days after surgery and divided into POCD group and non-POCD group according to neurologic evaluation results.We recorded the clinical dates including age,gender,education level,New euroscore II,and so on.The blood samples was collected at five time points: before operation(8 o 'clock in the morning on the day of surgery),30 minutes after CPB,24 h after CPB,48 h after CPB,72 h after CPB,and to determine serum S100 B protein concentration by ELISA.Single factor and binary logistic regression analyses was used to analysis the independent risk factors of early POCD.Results:POCD group were 20 cases,non-POCD group were 60 cases.Logistic regression analysis showed that the independent risk factors for early POCD to be hyperglycemia [OR=6.038,95% CI:1.202-30.337],operation time [OR=6.423,95%CI:1.276-32.332] and Aspartate Aminotransferase(AST,2 times higher than normal)[OR=12.878,95% CI:2.289-72.445].Compared with non-POCD group,the level of serum S100 B protein at the intraoperative and postoperative each time point in POCD group were obviously higher(P<0.05),and was still higher than preoperative levels at 72 h after CPB(P < 0.05).The level of serum S100 B protein at48 h(1.57±0.40 ?g/L)after CPB was dropped to preoperative levels(1.43±0.43 ?g/L)at non-POCD group(P>0.05).Conclusion:Long operation time,perioperative hyperglycemia and high AST are independent predictors and the serum S100 B protein is significant marker of early POCD.