[Analysis of the inflammatory response in elderly hospitalized patients].
This report examines the clinical features, biological characteristics and future potential of 146 hospitalized elderly patients (average age: 83.9 +/- 7 years) with and without inflammation at admission. The prognostic values of CRP and orosomucoid tests were assessed. CRP and orosomucoid were measured within three days following admission, and were elevated in 58 patients (40%). Compared with patients free of inflammation, these patients had more diseases per individual (more than two diseases: 70% versus 50%, p < 0.01), lower albumin, prealbumin and cholesterol levels and, when in hospital, more frequent pulmonary infections (31 vs 12%, p < 0.05) and higher death rate (20% vs 5%, p < 0.05). CRP increased with age (R = 0.23, p < 0.01) independently of inflammation and was neither correlated to infections nor to mortality unlike the orosomucoid. An inflammatory response following admission was related to an increase of pulmonary infections and mortality in hospital. Orosomucoid had a better prognostic value, compared with CRP. These data are in agreement with the mechanisms of transcriptional regulation of certain genes (NFkappaB, IL6, orosomucoid) involved in inflammation and their modification through ageing.
Henry
O
O
Service de Médecine Gériatrique, Hôpital Charles-Richet (AP-HP), Villiers-le-Bel.
Jourdan
B
B
Duviquet
M
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D004194:Disease; D005260:Female; D005786:Gene Expression Regulation; D006760:Hospitalization; D006801:Humans; D008171:Lung Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis; D010343:Patient Admission; D011228:Prealbumin / Q000032:analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012141:Respiratory Tract Infections / Q000150:complications; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology*
D009961:Orosomucoid; D011228:Prealbumin; D012709:Serum Albumin; D002097:C-Reactive Protein; D002784:Cholesterol
Analyse de la réponse inflammatoire chez des malades âgés hospitalisés.