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

Thaeter, M.; Knobe, Matthias; Kerckhove, M. Vande; Böhle, Franziska; Herold, J; Verhaven, E.; Pape, Hans-Christian

doi:10.1007/s00068-016-0719-9

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Similarly, a trend towards an age-dependent increase for IL-6 plasma cytokine levels was observed in aged rodents that underwent minor surgery. Consistent with these findings, a clinical study demonstrated that aged patients that received surgical treatment have higher IL-6 serum levels with respect to middle-aged surgical patients (Thaeter et al, 2016). This may be explained, at least in part, by the amplified production of proinflammatory cytokines by aged peripheral blood mononuclear cells (PBMCs) (Fagiolo et al, 1993).…”

Section: Circulating Inflammatory Markers In Serum Plasma and Csfmentioning

confidence: 67%

Pathophysiological and behavioral effects of systemic inflammation in aged and diseased rodents with relevance to delirium: A systematic review

Schreuder

Eggen

Biber

et al. 2017

Brain, Behavior, and Immunity

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Section: Circulating Inflammatory Markers In Serum Plasma and Csfmentioning

confidence: 67%

Pathophysiological and behavioral effects of systemic inflammation in aged and diseased rodents with relevance to delirium: A systematic review

Schreuder

Eggen

Biber

et al. 2017

Brain, Behavior, and Immunity

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“…Screening of full-text articles identified a total of 45 studies that met eligibility criteria. 17–61 Search results and study selection are summarized in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis Examining the Impact of Age on Perioperative Inflammatory Biomarkers

Patel

Zhang

Liao

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND: Dysregulation of immune responses to surgical stress in older patients and those with frailty may manifest as differences in inflammatory biomarkers. We conducted a systematic review and meta-analysis to examine differences in perioperative inflammatory biomarkers between older and younger patients, and between patients with and without frailty. METHODS: MEDLINE, Embase, Cochrane, and CINAHL databases were searched (Inception to June 23, 2020). Observational or experimental studies reporting the perioperative level or activity of biomarkers in surgical patients stratified by age or frailty status were included. The primary outcome was inflammatory biomarkers (grouped by window of ascertainment: pre-op; post-op: <12 hours, 12–24 hours, 1–3 days, 3 days to 1 week, and >1 week). Quality assessment was conducted using the Newcastle-Ottawa Scale. Inverse-variance, random-effects meta-analysis was conducted. RESULTS: Forty-five studies (4263 patients) were included in the review, of which 36 were pooled for meta-analysis (28 noncardiac and 8 cardiac studies). Two studies investigated frailty as the exposure, while the remaining investigated age. In noncardiac studies, older patients had higher preoperative levels of interleukin (IL)-6 and C-reactive protein (CRP), lower preoperative levels of lymphocytes, and higher postoperative levels of IL-6 (<12 hours) and CRP (12–24 hours) than younger patients. In cardiac studies, older patients had higher preoperative levels of IL-6 and CRP and higher postoperative levels of IL-6 (<12 hours and >1 week). CONCLUSIONS: Our findings demonstrate a paucity of frailty-specific studies; however, the presence of age-associated differences in the perioperative inflammatory response is consistent with age-associated states of chronic systemic inflammation and immunosenescence. Additional studies assessing frailty-specific changes in the systemic biologic response to surgery may inform the development of targeted interventions.

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“…For example, proximal femur fracture increased serum concentrations of IL-6 more in patients older than 70 years than in patients younger than 50 years [119]. Furthermore, after surgery, IL-6 concentrations increase more rapidly and remain elevated longer in elderly than middle aged people [120,121]. Based on these observations, Hazeldine et al proposed a model of age-differences in the inflammatory response to injury (Figure 6) [121].…”

Section: Introductionmentioning

confidence: 99%

Systemic Bone Loss After Fracture

Osipov

Emami

Christiansen

2018

Clinic Rev Bone Miner Metab

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A history of prior fracture is the most reliable indicator of prospective fracture risk. Increased fracture risk is not confined to the region of the prior fracture, but is operant at all skeletal sites, providing strong evidence of systemic bone loss after fracture. Animal and human studies suggest that systemic bone loss begins shortly after fracture and persists for several years in humans. In fact, bone quantity and bone quality may never fully return to their pre-fracture levels, especially in older subjects, demonstrating a need for improved understanding of the mechanisms leading to systemic bone loss after fracture in order to reduce subsequent fracture risk. Although the process remains incompletely understood, mechanical unloading (disuse), systemic inflammation, and hormones that control calcium homeostasis may all contribute to systemic bone loss. Additionally, individual factors can potentially affect the magnitude and time course of systemic bone loss and recovery. The magnitude of systemic bone loss correlates positively with injury severity and age. Men may also experience greater bone loss or less recovery than women after fracture. This review details the current understanding of systemic bone loss following fracture, including possible underlying mechanisms and individual factors that may affect this injury response.

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

Cited by 8 publications

References 17 publications

Pathophysiological and behavioral effects of systemic inflammation in aged and diseased rodents with relevance to delirium: A systematic review

Pathophysiological and behavioral effects of systemic inflammation in aged and diseased rodents with relevance to delirium: A systematic review

A Systematic Review and Meta-Analysis Examining the Impact of Age on Perioperative Inflammatory Biomarkers

Systemic Bone Loss After Fracture

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