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

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Interleukin-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.

Methods

Data 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.

Results

25 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.

Conclusion

Both 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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Authors and Affiliations

  1. Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany

    M. Thaeter, M. Knobe, M. Vande Kerckhove, F. Böhle, J. Herold & H.-C. Pape

  2. Department of Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany

    M. Thaeter, M. Knobe, M. Vande Kerckhove, F. Böhle, J. Herold & H.-C. Pape

  3. Department of Orthopaedic Surgery, St. Nicolaus Hospital, Hufengasse 4, 4700, Eupen, Belgium

    E. Verhaven

Authors
  1. M. Thaeter
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  2. M. Knobe
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  3. M. Vande Kerckhove
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  4. F. Böhle
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  5. J. Herold
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  6. E. Verhaven
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  7. H.-C. Pape
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Corresponding author

Correspondence to M. Thaeter.

Ethics declarations

Ethical Approval

The study protocol was approved by the Ethics Committee oft the Medical Faculty of the RWTH Aachen (Reference Number 10-027, EK004/11) and was conducted according to the ethical standards of the Declaration of Helsinki (1964) and its amendments. In all cases informed consent was obtained by the patient or close relatives.

Conflict of interest

Mathias Thaeter, Matthias Knobe, Michiel Vande Kerckhove, Franziska Böhle, Eddy Verhaven, Hans-Christoph Pape declare that they have no conflict of interest.

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Thaeter, M., Knobe, M., Vande Kerckhove, M. et al. Perioperative inflammatory response in major fracture: do geriatric patients behave differently?. Eur J Trauma Emerg Surg 42, 547–551 (2016). https://doi.org/10.1007/s00068-016-0719-9

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  • DOI: https://doi.org/10.1007/s00068-016-0719-9

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