title: Cytokine-release patterns in elderly patients with systemic inflammatory response syndrome.
abstract: BACKGROUND
  Information is scarce about the inflammatory responses to infection in elderly patients.
  
  
  OBJECTIVE
  To investigate the inflammatory pattern in elderly patients with systemic inflammatory response syndrome (SIRS).
  
  
  METHODS
  We assessed the value of pro-inflammatory cytokines (TNF-alpha, IL-6, IL-1beta) and C-reactive protein (CRP) in elderly patients with SIRS at the time of consultation in the emergency room and on the fourth day of hospitalization.
  
  
  RESULTS
  Of 100 patients with SIRS, 92 had a clinical suspicion of infection and 46 were microbiologically confirmed. Basal TNF-alpha and IL-6 levels were higher in patients with bacteremia (p < 0.001 and p = 0.017, respectively). Basal levels of TNF-alpha (p < 0.001) and fourth-day levels of CRP (p = 0.004), TNF-alpha (p < 0.001) and IL-6 (p = 0.002) had a positive correlation with the length of hospitalization. Higher IL-6 levels on the fourth day showed a correlation with mortality (p = 0.016), while the other cytokines and CRP did not show this association.
  
  
  CONCLUSIONS
  Febrile elderly patients showed an inflammatory response pattern to infection equivalent to that reported in younger patients. Despite some limitations of our study, among febrile elderly patients, pro-inflammatory cytokine levels can be good markers for evaluating the prognosis of infections.
authors: Department of Infectious Diseases, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. amoreno@medicina.ub.es
authors: Luis
authors: L
authors: Marti
authors: Carlos
authors: C
authors: Cervera
authors: Xavier
authors: X
authors: Filella
authors: Jose Luis
authors: JL
authors: Marin
authors: Manuel
authors: M
authors: Almela
authors: Asunción
authors: A
authors: Moreno
mesh_terms: D018806:APACHE; D000368:Aged; D016470:Bacteremia / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D005260:Female; D005334:Fever / Q000382:microbiology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000276:immunology* / Q000382:microbiology / Q000401:mortality
chemical_list: D016207:Cytokines; D002097:C-Reactive Protein