دورية أكاديمية
Melanin-Concentrating Hormone Is Associated With Delayed Neurocognitive Recovery in Older Adult Patients With Preoperative Sleep Disorders Undergoing Spinal Anesthesia.
العنوان: | Melanin-Concentrating Hormone Is Associated With Delayed Neurocognitive Recovery in Older Adult Patients With Preoperative Sleep Disorders Undergoing Spinal Anesthesia. |
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المؤلفون: | Gao Y; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Zhou Q; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Li H; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Zhao Y; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China., Zhu H; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Zhang X; From the Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.; Department of Anesthesiology, Chifeng Municipal Hospital, Chifeng, China., Li Y; Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology, Tianjin, China. |
المصدر: | Anesthesia and analgesia [Anesth Analg] 2024 Mar 01; Vol. 138 (3), pp. 579-588. Date of Electronic Publication: 2023 Dec 05. |
نوع المنشور: | Observational Study; Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins Original Publication: Cleveland, International Anesthesia Research Society. |
مواضيع طبية MeSH: | Anesthesia, Spinal*/adverse effects , Hypothalamic Hormones*/cerebrospinal fluid, Humans ; Aged ; Melanins/cerebrospinal fluid ; Pituitary Hormones/cerebrospinal fluid |
مستخلص: | Background: Aging and preoperative sleep disorders are the main risk factors affecting postoperative cognitive outcomes. However, the pathogenesis of delayed neurocognitive recovery after surgery remains ambiguous, and there is still a lack of potential biomarkers for delayed neurocognitive recovery in older adult patients with preoperative sleep disorders. Our study aimed to explore the relationship between melanin-concentrating hormone (MCH) and delayed neurocognitive recovery early after surgery in older adult patients with preoperative sleep disorders. Methods: In this monocentric prospective observational study, 156 older adult patients (aged 65 years or older) with preoperative sleep disorders undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) were included at an academic medical center in Inner Mongolia, China, from October 2021 to November 2022, and all patients underwent spinal anesthesia. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess the preoperative sleep quality of all patients, and preoperative sleep disorders were defined as a score of PSQI >5. We measured the levels of cerebrospinal fluid (CSF) MCH and plasma MCH of all patients. The primary outcome was delayed neurocognitive recovery early after surgery. All patients received cognitive function assessment through the Montreal Cognitive Assessment (MoCA) 1 day before and 7 days after surgery (postoperative day 7 [POD7]). Delayed neurocognitive recovery was defined as a score of POD7 MoCA <26. The potential confounders included variables with P < .2 in the univariate logistic analysis, as well as the important risk factors of delayed neurocognitive recovery reported in the literature. Multivariable logistic regression model based on the Enter method assessed the association of MCH and delayed neurocognitive recovery in older adult patients with preoperative sleep disorders. Results: Fifty-nine (37.8%) older adult patients with preoperative sleep disorders experienced delayed neurocognitive recovery at POD7. Increase in CSF MCH levels (odds ratio [OR] for an increase of 1 pg/mL = 1.16, 95% confidence interval [CI], 1.09-1.23, P < .001) and decrease in plasma MCH levels (OR for an increase of 1 pg/mL = 0.92, 95% CI, 0.86-0.98, P = .003) were associated with delayed neurocognitive recovery, after adjusting for age, sex, education, baseline MoCA scores, American Society of Anesthesiologists (ASA) grade, and coronary heart disease (CHD). Conclusions: In older adult patients with preoperative sleep disorders, MCH is associated with the occurrence of delayed neurocognitive recovery after surgery. Preoperative testing of CSF MCH or plasma MCH may increase the likelihood of identifying the high-risk population for delayed neurocognitive recovery in older adult patients with preoperative sleep disorders. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 International Anesthesia Research Society.) |
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معلومات مُعتمدة: | 202202327 Inner Mongolia Autonomous Region Health Science and Technology Plan Project; SZR2022217 Chifeng Natural Science Foundation; 2022KJ232 Scientific Research Project of Tianjin Municipal Education Commission |
المشرفين على المادة: | 67382-96-1 (melanin-concentrating hormone) 0 (Hypothalamic Hormones) 0 (Melanins) 0 (Pituitary Hormones) |
تواريخ الأحداث: | Date Created: 20231205 Date Completed: 20240219 Latest Revision: 20240219 |
رمز التحديث: | 20240219 |
DOI: | 10.1213/ANE.0000000000006768 |
PMID: | 38051670 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1526-7598 |
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DOI: | 10.1213/ANE.0000000000006768 |