title: Inflammatory markers as predictors of postoperative adverse outcome in octogenarian surgical patients: an observational prospective study.
abstract: BACKGROUND
  The value of inflammatory proteins, interleukin-6 and alpha-1-acid glycoprotein as prognostic factors in elderly people undergoing surgery has not been determined yet.
  
  
  OBJECTIVE
  To know whether preoperatively determined inflammatory markers may predict the postoperative outcome of elderly patients undergoing surgery. A scoring system for predicting postoperative morbidity was assessed.
  
  
  METHODS
  Hospital-based observational prospective study, with geriatric surgical patients. Preoperative determination of following data: age, gender, scheduled or urgent operation, comorbid diseases, malignancy, physical, mental and nutritional profile. Biochemical markers of inflammation, C Reactive Protein, interleukin-6, and alpha-1-acid glycoprotein were also studied. Preoperative data and postoperative complications were recorded. Binary logistic regression analysis was used to obtain a morbidity risk prediction model.
  
  
  RESULTS
  A total of 225 patients were included. Fifty-five patients (24.4%) had postoperative complications, with a mortality rate of 5.3%. Binary logistic regression analysis showed an independent relation between morbidity and the variables malignancy, alpha-1-acid glycoprotein and interleukin-6. The risk (R) of postoperative morbidity adjusted by age was calculated. The model showed a 22.2% sensitivity, 94.8% specificity, and a percentage of correct classification of 78.3%. The area under the ROC curve was 0.781 (95% CI: 0.703-0.858).
  
  
  CONCLUSIONS
  An age-adjusted equation for predicting 30-day morbidity that included malignancy, serum IL-6 and alpha 1-acid glycoprotein levels may be useful for risk assessment in octogenarian surgical patients.
authors.affiliation: Servicio de Cirugía, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, España. Electronic address: sergio4762@yahoo.es.
authors.forename: Sergio
authors.initials: S
authors.lastname: González-Martínez
authors.affiliation: Epidemiología Clínica, Fundació Assaig, Consorci Sanitari Integral, Barcelona, España.
authors.forename: Noemí
authors.initials: N
authors.lastname: Olona Tabueña
authors.affiliation: Epidemiología Clínica, Fundació Assaig, Consorci Sanitari Integral, Barcelona, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Martín Baranera
authors.affiliation: Servicio de Cirugía, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, España.
authors.forename: Isidro
authors.initials: I
authors.lastname: Martí-Saurí
authors.affiliation: Servicio de Cirugía, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, España.
authors.forename: Josep Lluís
authors.initials: JL
authors.lastname: Moll
authors.affiliation: Servicio de Cirugía, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, España.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Morales García
authors.affiliation: Enfermería Clínica, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Borrell Grau
authors.affiliation: Servicio de Cirugía, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Pueyo Zurdo
mesh_terms: D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D009961:Orosomucoid / Q000032:analysis*; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D009961:Orosomucoid
keywords: Complicaciones postoperatorias; Edad mayor de 80 años; Evaluación de riesgo quirúrgico; Inflammation markers; Marcadores de inflamación; MeSH terms Aged 80 and over; Postoperative complications; Risk assessment