Postoperative interleukin-6 and cortisol concentrations in elderly patients with postoperative confusion.
OBJECTIVE
To investigate changes in plasma interleukin (IL)-6, cortisol or noradrenaline concentrations after surgery in elderly patients with postoperative confusion.


METHODS
We studied 80 patients aged 70-90 years undergoing abdominal surgery and measured plasma IL-6, cortisol or noradrenaline concentrations before surgery, at the end of surgery, and 24 and 48 h after surgery.


RESULTS
Plasma IL-6 concentrations in elderly patients with postoperative confusion were 83.2 +/- 30.5, 49.3 +/- 14.1 and 42.9 +/- 19.4 pg.ml(-1) at the end of surgery, and 24 and 48 h after surgery, respectively, being significantly higher than in elderly patients without postoperative confusion (58.0 +/- 37.5, 36.1 +/- 20.0 and 28.2 +/- 16.7 pg.ml(-1)). Plasma cortisol concentrations in elderly patients with postoperative confusion (42.2 +/- 7.8, 38.3 +/- 8.3 and 33.1 +/- 8.4 microg.dl(-1) at the end of surgery, and 24 and 48 h after surgery, respectively) were significantly higher than in elderly patients without postoperative confusion (32.9 +/- 6.7, 30.4 +/- 8.6 and 25.6 +/- 6.5 microg.dl(-1), respectively). There were no significant differences in plasma norepinephrine concentrations at all sampling points between elderly patients with and without postoperative confusion. However, plasma IL-6 and cortisol concentrations were related in elderly patients with postoperative confusion (at the end of surgery and 24 and 48 h after surgery). However, there was no relationship between plasma IL-6 and cortisol concentrations 24 and 48 h after surgery in elderly patients without postoperative confusion.


CONCLUSIONS
Elderly patients with postoperative confusion had increased plasma IL-6 and cortisol concentrations. The interaction between IL-6 and cortisol after surgery is associated with developing postoperative confusion in the elderly patients.
Kudoh
Akira
A
Department of Anesthesiology, Hirosaki National Hospital, Hirosaki, Japan.
Takase
Hajime
H
Katagai
Hiroshi
H
Takazawa
Tomoko
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000276:immunology* / Q000378:metabolism; D015984:Causality; D003221:Confusion / Q000097:blood* / Q000276:immunology*; D016207:Cytokines / Q000097:blood / Q000276:immunology / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D007030:Hypothalamo-Hypophyseal System / Q000276:immunology / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009490:Neurosecretory Systems / Q000276:immunology / Q000378:metabolism; D009638:Norepinephrine / Q000097:blood / Q000276:immunology; D011183:Postoperative Complications / Q000097:blood* / Q000276:immunology* / Q000523:psychology; D013312:Stress, Physiological / Q000097:blood / Q000276:immunology; D013564:Sympathetic Nervous System / Q000276:immunology / Q000378:metabolism; D013997:Time Factors; D015854:Up-Regulation / Q000276:immunology
D016207:Cytokines; D015850:Interleukin-6; D006854:Hydrocortisone; D009638:Norepinephrine