• Yuling Chen, Sai Lu, Ying Wu, Yuzhi Shen, Haibo Zhao, Shu Ding, Xinwei Feng, Li Sun, Xiangjun Tao, Jinglian Li, Ruiying Ma, Weiwei Liu, Fangqin Wu, and Yadi Feng.
• Yuling Chen and Fangqin Wu are doctoral candidates, Ying Wu is dean and professor, Shu Ding is a postgraduate student, Xinwei Feng is a teacher, Li Sun, Xiangjun Tao, and Jinglian Li are postgraduate students, Ruiying Ma and Weiwei Liu are teachers, and Yadi Feng is a postgraduate student, School of Nursing, Capital Medical University, Beijing, China. Sai Lu is a senior lecturer and research fellow, College of Health and Biomedicine, Institute for Health and Sport, Victoria University, Mel-bourne, Australia. Yuzhi Shen and Haibo Zhao are charge nurses, Heart Center, Beijing Chao-Yang Hospital, Beijing, China.
• Am. J. Crit. Care. 2019 Nov 1; 28 (6): 462-470.

BackgroundSerum level of interleukin 6 (IL-6) is known to be associated with postoperative delirium. However, no consensus has emerged on the postoperative time point at which IL-6 level may predict postoperative delirium after coronary artery bypass graft surgery.ObjectivesTo compare trends in IL-6 levels in patients with and without postoperative delirium and to examine the relationship between IL-6 levels at different times and postoperative delirium after coronary artery bypass graft.MethodsA prospective cohort study of patients who underwent their first elective isolated coronary artery bypass graft between November 2013 and August 2015 at a cardiac intensive care unit in Beijing, China. Concentrations of IL-6 were measured before the operation and at the 6th, 12th, and 18th postoperative hours. Participants were assessed for postoperative delirium twice daily for 5 days. Univariate and multivariate logistic regression analyses were done to determine associations between IL-6 levels at different time points, postoperative changes in IL-6 levels, and the occurrence of postoperative delirium.ResultsPostoperative delirium was diagnosed in 85 of 266 patients (32%). Levels of IL-6 were significantly higher in patients with postoperative delirium than in patients without it at the 6th, 12th, and 18th postoperative hours (P = .03, .004, and .001, respectively). Change in IL-6 level (odds ratio, 2.97; 95% CI, 1.20-7.31; P = .02) and IL-6 level of 583 pg/mL or higher at the 18th postoperative hour (odds ratio, 5.20; 95% CI, 1.84-14.70; P = .002) were associated with higher incidence of postoperative delirium.ConclusionInterleukin 6 level (≥ 583 pg/mL) at the 18th postoperative hour may serve as a potent predictor of postoperative delirium in coronary artery bypass graft patients.©2019 American Association of Critical-Care Nurses.

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