Literature DB >> 18691278

Time-course of cytokines during delirium in elderly patients with hip fractures.

Barbara C van Munster1, Johanna C Korevaar, Aeilko H Zwinderman, Marcel Levi, W Joost Wiersinga, Sophia E De Rooij.   

Abstract

OBJECTIVES: To compare the time-course of cytokine levels in patients with and without delirium and investigate differences in cytokine concentrations in delirium subtypes.
DESIGN: Prospective cohort study.
SETTING: Academic Medical Center, Amsterdam, 2005 through 2007. PARTICIPANTS: Patients aged 65 and older admitted for surgery after hip fracture. MEASUREMENTS: Experienced geriatric physicians used the Confusion Assessment Method to assess delirium and the Delirium Symptom Interview to assess delirium subtype. Tumor necrosis factor alpha (TNF-alpha) and interleukin (IL)-1beta, IL-6, IL-8, IL-10, and IL-12 were assayed in repeated serum samples using a cytometric bead array immunoassay.
RESULTS: Of 221 admitted patients, 98 (mean age 84, 50 patients with delirium) were included, resulting in a total of 324 samples. Ninety-six percent of these samples had TNF-alpha, IL-1beta, and IL-10 levels below the reliable detection level. Differences between patients with and without delirium were observed in IL-6 (median 51 vs 36 pg/mL, P=.01) and IL-8 (median 15 vs 9 pg/mL, P=.03) levels. Changes over time in IL-6 and IL-8 levels in patients with delirium differed significantly from changes in levels in patients without delirium. The highest levels of IL-6 were present during delirium, and the highest levels of IL-8 were present before the development of delirium. Patients with the hyperactive (median 71 pg/mL) or mixed (median 73 pg/mL) subtype of delirium had higher IL-6 levels than patients with hypoactive delirium (median 16 pg/mL) (P=.02).
CONCLUSION: IL-6 and IL-8 may contribute to the pathogenesis of postoperative delirium in elderly people. IL-6 may play a role in the hyperactive behavior of delirium.

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Year:  2008        PMID: 18691278     DOI: 10.1111/j.1532-5415.2008.01851.x

Source DB:  PubMed          Journal:  J Am Geriatr Soc        ISSN: 0002-8614            Impact factor:   5.562


  56 in total

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5.  Effect of melatonin on incidence of delirium among patients with hip fracture: a multicentre, double-blind randomized controlled trial.

Authors:  Annemarieke de Jonghe; Barbara C van Munster; J Carel Goslings; Peter Kloen; Carolien van Rees; Reinder Wolvius; Romuald van Velde; Marcel Levi; Rob J de Haan; Sophia E de Rooij
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Review 9.  Delirium in elderly adults: diagnosis, prevention and treatment.

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