Cytokine-release patterns in elderly patients with systemic inflammatory response syndrome.
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.
Marti
Luis
L
Department of Infectious Diseases, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. amoreno@medicina.ub.es
Cervera
Carlos
C
Filella
Xavier
X
Marin
Jose Luis
JL
Almela
Manuel
M
Moreno
Asunción
A
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
D016207:Cytokines; D002097:C-Reactive Protein