Surgery-induced inflammation in relation to age, muscle endurance, and self-perceived fatigue.
BACKGROUND
Elective abdominal surgery can be considered as a model for an important acute inflammatory trigger in human participants. The aim of the study was to explore the effect of surgery-induced inflammation on muscle strength, endurance, and self-perceived fatigue and its relation with age.


METHODS
Sixty-six elective abdominal surgery patients aged 24-91 years were assessed before and at the second and fourth day after surgical intervention. Outcome parameters were grip strength, muscle endurance, fatigue subscale of the Profile of Mood State and visual analog scale for pain, and the circulating inflammatory mediators C-reactive protein, interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-alpha).


RESULTS
All parameters worsened postoperatively (p < .01) and remained significantly (p < .05) worse until the fourth day postsurgery, except for TNF-alpha (no significant change). Older age was related to higher surgery-induced IL-6 levels at the second (p < .05) and fourth postoperative (p < .01) day and to worse self-perceived fatigue and muscle endurance (both p < .05) at the fourth postoperative day. Higher pain levels at the second day following surgery was related to more self-perceived fatigue (p < .05). Worsening muscle endurance following surgery was significantly related to higher IL-6 release following surgery (p < .01) and self-perceived fatigue (p < .05) at the fourth day following the intervention. Age and surgery-induced increase in circulating IL-6 at Day 4 postsurgery was highest in patients showing both worsened muscle endurance and self-perceived fatigue (p < .05).


CONCLUSIONS
Surgery-induced inflammation is related to reduced muscle endurance and the sensation of fatigue. Elderly patients suffer from a higher impact of surgery on muscle endurance.
Bautmans
I
I
Frailty in Ageing Research Department, Vrije Universiteit Brussel, Laarbeeklaan, Belgium.
Njemini
R
R
De Backer
J
J
De Waele
E
E
Mets
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005221:Fatigue / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D015850:Interleukin-6 / Q000097:blood; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D018763:Muscle Fatigue / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology; D009391:Nephelometry and Turbidimetry; D010807:Physical Endurance / Q000502:physiology*; D011183:Postoperative Complications / Q000097:blood / Q000503:physiopathology*; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein