Cytokine-release patterns in elderly patients with systemic inflammatory response syndrome

Gerontology. 2007;53(5):239-44. doi: 10.1159/000101436. Epub 2007 Mar 30.

Abstract

Background: Information is scarce about the inflammatory responses to infection in elderly patients.

Objective: To investigate the inflammatory pattern in elderly patients with systemic inflammatory response syndrome (SIRS).

Methods: We assessed the value of pro-inflammatory cytokines (TNF-alpha, IL-6, IL-1beta) and C-reactive protein (CRP) in elderly patients with SIRS at the time of consultation in the emergency room and on the fourth day of hospitalization.

Results: Of 100 patients with SIRS, 92 had a clinical suspicion of infection and 46 were microbiologically confirmed. Basal TNF-alpha and IL-6 levels were higher in patients with bacteremia (p < 0.001 and p = 0.017, respectively). Basal levels of TNF-alpha (p < 0.001) and fourth-day levels of CRP (p = 0.004), TNF-alpha (p < 0.001) and IL-6 (p = 0.002) had a positive correlation with the length of hospitalization. Higher IL-6 levels on the fourth day showed a correlation with mortality (p = 0.016), while the other cytokines and CRP did not show this association.

Conclusion: Febrile elderly patients showed an inflammatory response pattern to infection equivalent to that reported in younger patients. Despite some limitations of our study, among febrile elderly patients, pro-inflammatory cytokine levels can be good markers for evaluating the prognosis of infections.

MeSH terms

  • APACHE
  • Aged
  • Bacteremia / metabolism
  • C-Reactive Protein / analysis
  • Cytokines / blood*
  • Female
  • Fever / microbiology
  • Humans
  • Male
  • Prospective Studies
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / immunology*
  • Systemic Inflammatory Response Syndrome / microbiology
  • Systemic Inflammatory Response Syndrome / mortality

Substances

  • Cytokines
  • C-Reactive Protein