title: Cortisol, interleukins and S100B in delirium in the elderly.
abstract: In independent studies delirium was associated with higher levels of cortisol, interleukin(IL)s, and S100B. The aim of this study was to simultaneously compare cortisol, IL-6, IL-8, and S100B levels in patients aged 65years and older admitted for hip fracture surgery with and without delirium. Cortisol, IL-6, IL-8, and S100B were assayed in repeated blood samples. 120 patients (mean age 84years, 62 patients with delirium) were included. Highest levels of IL-8 (27.1, 95% Confidence Interval (CI): 13.6-53.1pg/ml) and cortisol (666, 95% CI: 475-859nmol/L) were before delirium, but of IL-6 (84.3, 95% CI: 46.5-151.4pg/mL) and S100B (0.18, 95% CI: 0.12-0.24 microg/L) during delirium. In multivariable analysis cortisol, LogIL-6, and LogS100B were significantly associated with delirium, but adjusted for pre-existing cognitive impairment, only LogS100B remained significantly associated. Cortisol, IL-6 and S100B may have a role in the pathogenesis of delirium, but S100B is the strongest independent marker.
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, The Netherlands. b.c.vanmunster@amc.uva.nl
authors.forename: Barbara C
authors.initials: BC
authors.lastname: van Munster
authors.forename: Peter H
authors.initials: PH
authors.lastname: Bisschop
authors.forename: Aeilko H
authors.initials: AH
authors.lastname: Zwinderman
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Korevaar
authors.forename: Erik
authors.initials: E
authors.lastname: Endert
authors.forename: W Joost
authors.initials: WJ
authors.lastname: Wiersinga
authors.forename: Hannah E
authors.initials: HE
authors.lastname: van Oosten
authors.forename: J Carel
authors.initials: JC
authors.lastname: Goslings
authors.forename: Sophia E J A
authors.initials: SE
authors.lastname: de Rooij
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003693:Delirium / Q000097:blood* / Q000150:complications; D005260:Female; D006620:Hip Fractures / Q000097:blood / Q000150:complications; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007118:Immunoassay; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D006854:Hydrocortisone