{
  "abstract": "Introduction Postoperative neuropsychological disorders including delirium, cognitive dysfunction and emotional distress are common after cardiac surgery and are linked to reduced quality of life, morbidity and mortality. Reliable preoperative risk factors remain difficult to identify. This study investigates stress-related parameters as predictors of postoperative neuropsychological disorders in patients undergoing cardiac surgery.Methods and analysis In this prospective study, 240 patients undergoing elective cardiac surgery (coronary artery bypass grafting: n=120, aortic valve replacement: n=120) with extracorporeal circulation at the Kerckhoff-Clinic Bad Nauheim (Germany) will be enrolled. Preoperative stress factors will be assessed using measures of stress-related personality traits, perceived stress, anxiety, depression, salivary cortisol and heart rate variability. Postoperative neuropsychological disorders will be evaluated through diagnosis of delirium in both the intensive care unit and on the standard ward. Additional neurocognitive dysfunctions and emotional distress will be assessed at hospital discharge and 3 months postoperatively, with corresponding preoperative baseline measurements.Discussion If stress measures prove to be predictive, they may enhance understanding of postoperative neurocognitive and emotional disorders and facilitate the development of risk stratification algorithms, enabling more effective preventive strategies for high-risk patients.Ethics and dissemination The study was approved by the Ethics Committee of Justus Liebig University Giessen (Ref.: 54/24) and is conducted in accordance with the Declaration of Helsinki. Written informed consent will be obtained from the patients. Results will be disseminated through peer-reviewed publications and scientific conferences.Trial registration number Prospectively registered with the German Clinical Trials Register (DRKS00035318).",
  "authors": [
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Neurology, University Hospitals Giessen and Marburg, Giessen, Germany",
        "Department of Geriatrics, Health Centre Wetterau, Bad Nauheim, Germany"
      ],
      "name": "Marius Butz"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Neurology, University Hospitals Giessen and Marburg, Giessen, Germany"
      ],
      "name": "Rolf Meyer"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Neurology, University Hospitals Giessen and Marburg, Giessen, Germany",
        "Private Neurology Practice \"Die Neurologen”, Bad Nauheim, Germany"
      ],
      "name": "Tibo Gerriets"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Psychology, Justus Liebig University Giessen, Giessen, Germany"
      ],
      "name": "Carolin Hänsel"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Biology, Philipps University Marburg, Marburg, Germany"
      ],
      "name": "Hannah Schmidt"
    },
    {
      "affiliations": [
        "Kassel School of Medicine, University of Southampton, Southampton, UK"
      ],
      "name": "Jana Yasemin Bach"
    },
    {
      "affiliations": [
        "Department of Biology, Justus Liebig University Giessen, Giessen, Germany"
      ],
      "name": "Alicia Marek"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Neurology, University Hospitals Giessen and Marburg, Giessen, Germany",
        "Private Neurology Practice \"Die Neurologen”, Bad Nauheim, Germany"
      ],
      "name": "Marlene Tschernatsch"
    },
    {
      "affiliations": [
        "Department of Neurology, University Hospitals Giessen and Marburg, Giessen, Germany"
      ],
      "name": "Omar Alhaj-Omar"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Neurology, Technische Universität Dresden, University Hospital Carl Gustav Carus, Dresden, Germany"
      ],
      "name": "Patrick Schramm"
    },
    {
      "affiliations": [
        "Department of Neurology, University Hospitals Giessen and Marburg, Giessen, Germany"
      ],
      "name": "Heidrun H Krämer"
    },
    {
      "affiliations": [
        "Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany"
      ],
      "name": "Yeong-Hoon Choi"
    },
    {
      "affiliations": [
        "Department of Cardiology and Angiology, University Hospital Giessen, Giessen, Germany",
        "Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany"
      ],
      "name": "Samuel Sossalla"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany"
      ],
      "name": "Till Keller"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Cardiac Surgery, Kerckhoff Heart Center, Bad Nauheim, Germany"
      ],
      "name": "Markus Schoenburg"
    },
    {
      "affiliations": [
        "Campus Kerckhoff, Heart & Brain Research Group, Kerckhoff Clinic, Justus Liebig University Giessen, Bad Nauheim, Germany",
        "Department of Neurology, University Hospitals Giessen and Marburg, Giessen, Germany"
      ],
      "name": "Martin Juenemann"
    }
  ],
  "title": "Preoperative stress markers as predictors of postoperative neuropsychological disorders in cardiac surgery patients: protocol for a single-centre prospective observational study (CAVALIR)",
  "uid": "0208da4a-e913-5280-a432-8680cac24e87"
}