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Comparison of procalcitonin, a potentially new inflammatory biomarker of frailty, to interleukin-6 and C-reactive protein among older Chinese hospitalized patients

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Abstract

Aim

Procalcitonin (PCT) has predictive value for patients with infectious diseases, but has not been studied in frailty. The purpose of this study was to compare PCT to two other inflammatory biomarkers [interleukin-6 (IL-6)] and C-reactive protein (CRP) in their association with frailty among older hospitalized patients.

Methods

Retrospective study of inpatients (June–December, 2016), who had all three biomarkers measured within 24 h of admission. Frailty was defined according to the Chinese version of a validated frailty scale. Due to the association of biomarkers with infection, we divided patients into “non-infected” (no pneumonia or other infections) and “pneumonia” (using standard criteria) groups.

Results

Of 435 patients (mean age 81.6 ± 8.6 years), 181 (41.6%) were designated the non-infected group and 254 (58.4%) the pneumonia group. Prevalence of frailty in the non-infected group was 32.0% (58/181) and frailty (univariate analysis) was associated with higher PCT and IL-6 levels but not CRP. Prevalence of frailty in the pneumonia group was 40.2% (102/254) and frailty was associated with all three biomarkers. In multivariable analysis adjusting for age, gender, smoking, alcohol use, hemoglobin, albumin, neutrophils and creatinine, PCT (not IL-6 and CRP) was associated with frailty in the non-infected group (OR = 5.244; 95% CI, 1.622–16.947; P = 0.006) and none of the biomarkers were associated with frailty in the pneumonia group.

Conclusions

Although the study is limited due to the retrospective methods, PCT but not IL-6 or CRP, was associated with frailty among older inpatients without infection. None of these biomarkers were associated with frailty among patients with pneumonia.

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Acknowledgements

This work was supported by National Natural Science Foundation of China (No. 81601220), the Sichuan Cadres Health Care Fund (CGY2016-101), the Project of Science and Technology Bureau of China and Sichuan Province (2017RZ0040) and the Science Foundation for Young Researchers of Sichuan University (2017SCU11044) and in part by the Collaborative Innovation Center of Sichuan for Elderly Care and Health (YLZBZ1503). We express our gratitude to the staff in the Department of Geriatrics, West China Hospital.

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Authors and Affiliations

  1. Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Chengdu, China

    Ying Yang, Jianghua Zhou, Yanjiao Shen & Birong Dong

  2. Department of Neurology, Fifth People’s Hospital of Chengdu, Chengdu, China

    Ying Yang & Jianghua Zhou

  3. National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China

    Ying Yang, Qiukui Hao, Li Cao, Jianghua Zhou, Li Su, Yanjiao Shen & Birong Dong

  4. Department of Geriatrics, The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Guoxue Street, Renming South Road, Chengdu, China

    Qiukui Hao, Joseph H. Flaherty, Li Cao, Li Su & Birong Dong

  5. Envision-Questcare Physician Services, Regional Medical Director of Geriatrics, Dallas, TX, USA

    Joseph H. Flaherty

Authors
  1. Ying Yang
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  2. Qiukui Hao
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  3. Joseph H. Flaherty
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  4. Li Cao
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  5. Jianghua Zhou
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  6. Li Su
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  7. Yanjiao Shen
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  8. Birong Dong
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Corresponding author

Correspondence to Birong Dong.

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Conflict of interest

No competing financial interests exist.

Ethical approval

Approval for the retrospective study was obtained from the research ethics committee of Sichuan University.

Informed consent

All the participants in our study signed the informed consent form.

Additional information

Ying Yang, Qiukui Hao are Co-first authors.

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Yang, Y., Hao, Q., Flaherty, J.H. et al. Comparison of procalcitonin, a potentially new inflammatory biomarker of frailty, to interleukin-6 and C-reactive protein among older Chinese hospitalized patients. Aging Clin Exp Res 30, 1459–1464 (2018). https://doi.org/10.1007/s40520-018-0964-3

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  • DOI: https://doi.org/10.1007/s40520-018-0964-3

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