• Eur J Trauma Emerg Surg · Oct 2016

    Perioperative inflammatory response in major fracture: do geriatric patients behave differently?

    • M Thaeter, M Knobe, M Vande Kerckhove, F Böhle, J Herold, E Verhaven, and H-C Pape.
    • Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany. mthaeter@ukaachen.de.
    • Eur J Trauma Emerg Surg. 2016 Oct 1; 42 (5): 547-551.

    PurposeInterleukin-6 is a mainly proinflammatory interleukin and an indicator for the magnitude of surgery. The IL-6 serum concentration correlates with injury severity, the extent of tissue trauma and has negative impact on prognosis. To date it is unclear whether the immunologic changes assessed are age dependent. The aim of this study is to compare the surgical inflammatory response in different age groups.MethodsData were collected at a level-1 university trauma center in a prospective, consecutive cohort study. IL-6 levels were analyzed via ELISA from venous blood samples of cohorts of injuries with typical peak incidence: patients with unstable fractures of the spine (SP) for a middle-aged group and patients with fractures of the proximal femur (PF) for a geriatric group. Surgical treatment was performed using minimal-invasive instrumentation.Results25 patients in group SP (age: 51 years ± 20) and 16 patients in the group PF (age: 73 years ± 16) were analysed. Group PF showed higher baseline IL-6 concentrations. Surgical treatment was followed by a significant increase of IL-6 levels in both groups 4 and 24 h postoperatively. Concentration profiles were similar, but increase was significantly higher in the PF group 4 h after surgery.ConclusionBoth the operative treatment of fractures in a middle-aged (SP) and a geriatric group (PF) lead to significant increasing of IL-6 levels. In view of a comparative surgical burden, these data suggest that age may be a confounding factor for a surgery induced pro-inflammatory response in the early postoperative stage.

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