title: Older age and type of surgery predict the early inflammatory response to hip trauma mediated by interleukin-6 (IL-6).
abstract: Hip trauma and surgery are associated with systemic inflammatory reaction. However, little evidence exists about the role of IL-6. In order to assess the inflammatory response, we evaluated white blood cell (WBC) count, C-reactive protein (CRP) and IL-6 dynamics in sequential pre- and postsurgical samples collected from 125 elderly patients (mean age 78+/-9 years) undergoing osteosynthesis (OS) for extracapsular hip fractures (n=69), hemiarthroplasty (HA) or urgent total hip arthroplasty for intracapsular fractures (UA) (n=35), and elective total hip arthroplasty for osteoarthrosis (OA) (n=21). Both preoperative CRP and IL-6 levels were higher in patients with intracapsular fractures. IL-6 levels reached peak values immediately after the surgery, while CRP peak levels were reached 48 h after the surgery. The overall inflammatory reaction was more intense in HA patients compared to the other subgroups. Independent of each other, older age and the hip fracture type affected the IL-6 response, while the CRP response depended only on the type of surgery. The abrupt increase in IL-6 immediately after the procedure suggests its involvement in the early stages of the postoperative inflammatory reaction after hip surgery. This reaction is particularly pronounced in elderly patients receiving HA.
authors.affiliation: First Medical Faculty, Charles University, General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Sedlár
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Kudrnová
authors.forename: David
authors.initials: D
authors.lastname: Erhart
authors.forename: Stanislav
authors.initials: S
authors.lastname: Trca
authors.forename: Jan
authors.initials: J
authors.lastname: Kvasnicka
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Krska
authors.forename: Jirí
authors.initials: J
authors.lastname: Mazoch
authors.forename: Ivana
authors.initials: I
authors.lastname: Malíková
authors.forename: Miroslav
authors.initials: M
authors.lastname: Zeman
authors.forename: Ales
authors.initials: A
authors.lastname: Linhart
mesh_terms: D000368:Aged; D005260:Female; D006620:Hip Fractures / Q000378:metabolism / Q000401:mortality / Q000601:surgery; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D011183:Postoperative Complications; D013514:Surgical Procedures, Operative / Q000145:classification* / Q000706:statistics & numerical data*; D015996:Survival Rate
chemical_list: D015850:Interleukin-6