title: Perioperative inflammatory response in major fracture: do geriatric patients behave differently?
abstract: OBJECTIVE
  Interleukin-6 is a mainly proinflammatory interleukin and an indicator for the magnitude of surgery. The IL-6 serum concentration correlates with injury severity, the extent of tissue trauma and has negative impact on prognosis. To date it is unclear whether the immunologic changes assessed are age dependent. The aim of this study is to compare the surgical inflammatory response in different age groups.
  
  
  METHODS
  Data were collected at a level-1 university trauma center in a prospective, consecutive cohort study. IL-6 levels were analyzed via ELISA from venous blood samples of cohorts of injuries with typical peak incidence: patients with unstable fractures of the spine (SP) for a middle-aged group and patients with fractures of the proximal femur (PF) for a geriatric group. Surgical treatment was performed using minimal-invasive instrumentation.
  
  
  RESULTS
  25 patients in group SP (age: 51 years ± 20) and 16 patients in the group PF (age: 73 years ± 16) were analysed. Group PF showed higher baseline IL-6 concentrations. Surgical treatment was followed by a significant increase of IL-6 levels in both groups 4 and 24 h postoperatively. Concentration profiles were similar, but increase was significantly higher in the PF group 4 h after surgery.
  
  
  CONCLUSIONS
  Both the operative treatment of fractures in a middle-aged (SP) and a geriatric group (PF) lead to significant increasing of IL-6 levels. In view of a comparative surgical burden, these data suggest that age may be a confounding factor for a surgery induced pro-inflammatory response in the early postoperative stage.
authors: Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany. mthaeter@ukaachen.de.|Department of Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany. mthaeter@ukaachen.de.
authors: M
authors: M
authors: Thaeter
authors: Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.|Department of Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.
authors: M
authors: M
authors: Knobe
authors: Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.|Department of Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.
authors: M
authors: M
authors: Vande Kerckhove
authors: Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.|Department of Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.
authors: F
authors: F
authors: Böhle
authors: Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.|Department of Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.
authors: J
authors: J
authors: Herold
authors: Department of Orthopaedic Surgery, St. Nicolaus Hospital, Hufengasse 4, 4700, Eupen, Belgium.
authors: E
authors: E
authors: Verhaven
authors: Harald Tscherne Research Laboratory for Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.|Department of Orthopaedic Trauma, Aachen University Medical Centre, Pauwelsst. 30, 52074, Aachen, Germany.
authors: H-C
authors: HC
authors: Pape
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005264:Femoral Fractures / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D015577:Geriatric Assessment; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014193:Trauma Centers; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Fracture; Geriatrics; Inflammatory response; Interleukin-6 (IL-6); Surgical burden; Trauma