title: Plasma mitochondrial DNA levels were independently associated with lung injury in elderly hip fracture patients.
abstract: BACKGROUND
  Hip fracture in the elderly can induce systemic inflammatory response (SIRS) and lung injury which increases the risk of lung infection and death. Mitochondrial DNA (mtDNA) plays a role in SIRS and lung injury in patients with multi-trauma, and also in patients with hip fractures. This study evaluated the potential value of plasma mtDNA in the early prognosis of lung injury in elderly fracture patients.
  
  
  METHODS
  This study enrolled 156 elderly patients with intertrochanteric fracture. Plasma mtDNA, IL-6, IL-10, prostaglandin E2 (PGE2) levels were measured at admission. Sixty-one and 31 patients were diagnosed with systemic inflammatory response syndrome (SIRS) and lung injury, respectively.
  
  
  RESULTS
  Plasma mtDNA levels were higher in hip fracture patients compared to healthy controls (P<0.001) and significantly higher in the lung injury subgroup compared to the lung injury absent subgroup (P<0.001). MtDNA levels were correlated with the SIRS score (r=0.446, P<0.001), IL-6 (r=0.506, P<0.001), IL-10 (r=0.523, P<0.001), and PGE2 (r=0.360, P<0.001). Logistic regression analysis revealed that plasma mtDNA, IL-6, PGE2 and SIRS score were independent predictors of the risk of lung injury.
  
  
  CONCLUSIONS
  Plasma mtDNA release induced by hip fracture in elderly patients, might be an early predictor of lung injury in these patients.
authors.affiliation: Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China.
authors.forename: Jian-Zheng
authors.initials: JZ
authors.lastname: Zhang
authors.affiliation: Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Mayo Clinic, Rochester, MN, 55901, USA.
authors.forename: Wen-Chun
authors.initials: WC
authors.lastname: Qu
authors.affiliation: Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China.
authors.forename: Xiao-Wei
authors.initials: XW
authors.lastname: Wang
authors.affiliation: Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China.
authors.forename: Ji-Xin
authors.initials: JX
authors.lastname: Ren
authors.affiliation: Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China.
authors.forename: Li
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Orthopedic, Beijing Army General Hospital, Beijing, 100700, China. Electronic address: suntiansheng-@163.com.
authors.forename: Tian-Sheng
authors.initials: TS
authors.lastname: Sun
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D004272:DNA, Mitochondrial / Q000097:blood*; D015232:Dinoprostone / Q000097:blood / Q000276:immunology; D005260:Female; D006620:Hip Fractures / Q000097:blood* / Q000150:complications* / Q000276:immunology; D006801:Humans; D016753:Interleukin-10 / Q000097:blood / Q000276:immunology; D015850:Interleukin-6 / Q000097:blood / Q000276:immunology; D055370:Lung Injury / Q000097:blood* / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000150:complications* / Q000276:immunology / Q000503:physiopathology
chemical_list: D004272:DNA, Mitochondrial; D015850:Interleukin-6; D016753:Interleukin-10; D015232:Dinoprostone
keywords: Hip fracture; Lung injury; Mitochondrial DNA; Predictor; Surgery; Systemic inflammatory response syndrome