Age-related differences in biomarkers of acute inflammation during hospitalization for sepsis.
Age-related differences in biomarkers of acute inflammation during hospitalization for sepsis.
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DOI：
10.1097/shk.0000000000000182
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发表时间：
2014-08
期刊：
影响因子：
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通讯作者：
Shapiro NI
中科院分区：
文献类型：
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作者：
Ginde AA;Blatchford PJ;Trzeciak S;Hollander JE;Birkhahn R;Otero R;Osborn TM;Moretti E;Nguyen HB;Gunnerson KJ;Milzman D;Gaieski DF;Goyal M;Cairns CB;Rivers EP;Shapiro NI
To evaluate age-related differences in inflammation biomarkers during the first 72 hours of hospitalization for sepsis. This was a secondary analysis of a prospective observational cohort of adult patients (n=855) from ten, urban, academic emergency departments with confirmed infection and two or more systemic inflammatory response syndrome criteria. We analyzed six inflammation-related biomarkers—chemokine (CC-motif) ligand-23 (CCL-23); C-reactive protein (CRP); interleukin-1 receptor antagonist (IL-1ra); neutrophil gelatinase-associated lipocalin (NGAL); peptidoglycan recognition protein (PGRP); and tumor necrosis factor receptor-1a (TNFR-1a)—measured at presentation and 3, 6, 12, 24, 48, or 72 hours later. The median age was 56 (IQR 43–72) years and sepsis severity was 38% sepsis, 16% severe sepsis without shock, and 46% septic shock; the overall 30-day mortality was 12%. Older age was associated with higher sepsis severity: 41% of subjects aged 18–34 years had severe sepsis or septic shock compared to 71% for those aged ≥65 years (p<0.001). In longitudinal models adjusting for demographics, co-morbidities, and infection source, older age was associated with higher baseline values for CCL-23, IL-1ra, NGAL, and TNFR-1a (all p<0.05). However, older adults had higher mean values during the entire 72-hour period only for NGAL and TNFR-1a, and higher final 72-hour values only for TNFR-1a. Adjustment or stratification by sepsis severity did not change the age-inflammation associations. While older adults had higher levels of inflammation at presentation and an increased incidence of severe sepsis and septic shock, these age-related differences in inflammation largely resolved during the first 72 hours of hospitalization.
