Perioperative inflammatory response and protein S-100β concentrations - relationship with post-operative cognitive dysfunction in elderly patients.
BACKGROUND
One major concern in about one third of elder patients after total hip-replacement surgery is post-operative cognitive dysfunction (POCD). Previous studies have suggested that cognitive impairment is accompanied with changes in serum S-100β protein (S-100β) and inflammatory markers. Thus, the aim of the current study was to investigate the value of serum S-100β and interleukin(IL)-1β, IL-6, tumour necrosis factor-α (TNF-α), and C-reactive protein (CRP) in reflecting POCD after total hip-replacement surgery.


METHODS
Forty-two elderly patients were enrolled, and 37 patients completed the follow-up. Serum S-100β protein and IL-1β, IL-6, TNF-α, and CRP were determined pre-operatively, as well as 1 h and 6 h post-operatively. Neuropsychological tests were performed pre-operatively, as well as on day 1, 3, and 7 post-operatively.


RESULTS
Seventeen (45.9%, 17/37) patients developed POCD 1 day after surgery, and three (8.1%, 3/37) developed POCD 7 days after surgery. [Correction added after publication 7 February 2012: in the preceding sentence (54.1%, 17/37) was corrected to (45.9%, 17/37)]. Patients with POCD 1 day after surgery had significantly higher serum levels of IL-6 at 6 h (135 ± 32 pg/ml vs. 91 ± 29 pg/ml, P < 0.05) and S-100β at 1 h (1872 ± 385 pg/ml vs. 1289 ± 143 pg/ml, P < 0.05. No significant post-operative change was detected in levels of TNF-α, IL-1, or CRP.


CONCLUSIONS
The serum levels of pro-inflammatory marker IL-6 and S-100β protein increased after total hip-replacement in elderly patients, and such increase may serve as predicting parameters for the occurrence of POCD.
Department of Anesthesiology, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University, China.
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YC
Li
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CH
Xi
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YF
An
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Dong
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M
Zhou
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D003072:Cognition Disorders / Q000378:metabolism / Q000473:pathology* / Q000523:psychology*; D004522:Educational Status; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology*; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood / Q000378:metabolism*; D009483:Neuropsychological Tests; D059035:Perioperative Period; D011183:Postoperative Complications / Q000378:metabolism / Q000473:pathology* / Q000523:psychology*; D011237:Predictive Value of Tests; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood / Q000378:metabolism*; D012959:Socioeconomic Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D053583:Interleukin-1beta; D015850:Interleukin-6; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein