Perioperative plasma melatonin concentration in postoperative critically ill patients: Its association with delirium

Shiho Yoshitaka, Moritoki Egi, Hiroshi Morimatsu, Tomoyuki Kanazawa, Yuichiro Toda, Kiyoshi Morita

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: Delirium is a common complication in postoperative critically ill patients. Although abnormal melatonin metabolism is thought to be one of the mechanisms of delirium, there have been few studies in which the association between alteration of perioperative plasma melatonin concentration and postoperative delirium was assessed. Materials: We conducted a prospective observational study to assess the association of perioperative alteration of plasma melatonin concentration with delirium in 40 postoperative patients who required intensive care for more than 48 hours. We diagnosed postoperative delirium using Confusion Assessment Method for the intensive care unit and measured melatonin concentration 4 times (before the operation as the preoperative value, 1 hour after the operation, postoperative day 1, and postoperative day 2). Results: Postoperative delirium occurred in 13 (33%) of the patients. Although there was no significant difference in preoperative melatonin concentration, δ melatonin concentration at 1 hour after the operation was significantly lower in patients with delirium than in those without delirium (- 1.1 vs 0 pg/mL, P = .036). After adjustment of relevant confounders, δ melatonin concentration was independently associated with risk of delirium (odds ratio, 0.50; P = .047). Conclusions: Delta melatonin concentration at 1 hour after the operation has a significant independent association with risk of postoperative delirium.

Original languageEnglish
Pages (from-to)236-242
Number of pages7
JournalJournal of Critical Care
Volume28
Issue number3
DOIs
Publication statusPublished - Jun 2013

Fingerprint

Delirium
Melatonin
Critical Illness
Social Adjustment
Confusion
Critical Care
Observational Studies
Intensive Care Units
Odds Ratio
Prospective Studies

Keywords

  • Critically ill
  • Melatonin
  • Postoperative delirium

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Perioperative plasma melatonin concentration in postoperative critically ill patients : Its association with delirium. / Yoshitaka, Shiho; Egi, Moritoki; Morimatsu, Hiroshi; Kanazawa, Tomoyuki; Toda, Yuichiro; Morita, Kiyoshi.

In: Journal of Critical Care, Vol. 28, No. 3, 06.2013, p. 236-242.

Research output: Contribution to journalArticle

@article{10186f94ef0f44adba7564bf8ffbfe08,
title = "Perioperative plasma melatonin concentration in postoperative critically ill patients: Its association with delirium",
abstract = "Purpose: Delirium is a common complication in postoperative critically ill patients. Although abnormal melatonin metabolism is thought to be one of the mechanisms of delirium, there have been few studies in which the association between alteration of perioperative plasma melatonin concentration and postoperative delirium was assessed. Materials: We conducted a prospective observational study to assess the association of perioperative alteration of plasma melatonin concentration with delirium in 40 postoperative patients who required intensive care for more than 48 hours. We diagnosed postoperative delirium using Confusion Assessment Method for the intensive care unit and measured melatonin concentration 4 times (before the operation as the preoperative value, 1 hour after the operation, postoperative day 1, and postoperative day 2). Results: Postoperative delirium occurred in 13 (33{\%}) of the patients. Although there was no significant difference in preoperative melatonin concentration, δ melatonin concentration at 1 hour after the operation was significantly lower in patients with delirium than in those without delirium (- 1.1 vs 0 pg/mL, P = .036). After adjustment of relevant confounders, δ melatonin concentration was independently associated with risk of delirium (odds ratio, 0.50; P = .047). Conclusions: Delta melatonin concentration at 1 hour after the operation has a significant independent association with risk of postoperative delirium.",
keywords = "Critically ill, Melatonin, Postoperative delirium",
author = "Shiho Yoshitaka and Moritoki Egi and Hiroshi Morimatsu and Tomoyuki Kanazawa and Yuichiro Toda and Kiyoshi Morita",
year = "2013",
month = "6",
doi = "10.1016/j.jcrc.2012.11.004",
language = "English",
volume = "28",
pages = "236--242",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",
number = "3",

}

TY - JOUR

T1 - Perioperative plasma melatonin concentration in postoperative critically ill patients

T2 - Its association with delirium

AU - Yoshitaka, Shiho

AU - Egi, Moritoki

AU - Morimatsu, Hiroshi

AU - Kanazawa, Tomoyuki

AU - Toda, Yuichiro

AU - Morita, Kiyoshi

PY - 2013/6

Y1 - 2013/6

N2 - Purpose: Delirium is a common complication in postoperative critically ill patients. Although abnormal melatonin metabolism is thought to be one of the mechanisms of delirium, there have been few studies in which the association between alteration of perioperative plasma melatonin concentration and postoperative delirium was assessed. Materials: We conducted a prospective observational study to assess the association of perioperative alteration of plasma melatonin concentration with delirium in 40 postoperative patients who required intensive care for more than 48 hours. We diagnosed postoperative delirium using Confusion Assessment Method for the intensive care unit and measured melatonin concentration 4 times (before the operation as the preoperative value, 1 hour after the operation, postoperative day 1, and postoperative day 2). Results: Postoperative delirium occurred in 13 (33%) of the patients. Although there was no significant difference in preoperative melatonin concentration, δ melatonin concentration at 1 hour after the operation was significantly lower in patients with delirium than in those without delirium (- 1.1 vs 0 pg/mL, P = .036). After adjustment of relevant confounders, δ melatonin concentration was independently associated with risk of delirium (odds ratio, 0.50; P = .047). Conclusions: Delta melatonin concentration at 1 hour after the operation has a significant independent association with risk of postoperative delirium.

AB - Purpose: Delirium is a common complication in postoperative critically ill patients. Although abnormal melatonin metabolism is thought to be one of the mechanisms of delirium, there have been few studies in which the association between alteration of perioperative plasma melatonin concentration and postoperative delirium was assessed. Materials: We conducted a prospective observational study to assess the association of perioperative alteration of plasma melatonin concentration with delirium in 40 postoperative patients who required intensive care for more than 48 hours. We diagnosed postoperative delirium using Confusion Assessment Method for the intensive care unit and measured melatonin concentration 4 times (before the operation as the preoperative value, 1 hour after the operation, postoperative day 1, and postoperative day 2). Results: Postoperative delirium occurred in 13 (33%) of the patients. Although there was no significant difference in preoperative melatonin concentration, δ melatonin concentration at 1 hour after the operation was significantly lower in patients with delirium than in those without delirium (- 1.1 vs 0 pg/mL, P = .036). After adjustment of relevant confounders, δ melatonin concentration was independently associated with risk of delirium (odds ratio, 0.50; P = .047). Conclusions: Delta melatonin concentration at 1 hour after the operation has a significant independent association with risk of postoperative delirium.

KW - Critically ill

KW - Melatonin

KW - Postoperative delirium

UR - http://www.scopus.com/inward/record.url?scp=84876869610&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876869610&partnerID=8YFLogxK

U2 - 10.1016/j.jcrc.2012.11.004

DO - 10.1016/j.jcrc.2012.11.004

M3 - Article

C2 - 23312124

AN - SCOPUS:84876869610

VL - 28

SP - 236

EP - 242

JO - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

IS - 3

ER -