Abstract | BACKGROUND: Surgical interventions result in a postoperative rise in circulating inflammatory cytokines and high molecular group box protein 1 ( HMGB1). Herein, the impact of a sedentary lifestyle and other age-related factors on the development of perioperative neurocognitive disorders (PND) following non- cardiac surgical procedures was assessed in an older (55-75 years-old) surgical population. METHODS: Prior to surgery, patients were asked questions regarding their sedentary behavior and daily habits. They also passed the Mini Mental State Examination (MMSE) and their blood circulating interleukin 6 (IL-6) and HMGB1 levels were assayed by ELISA. IL-6 and HMGB1 measurements were repeated respectively 6 and 24 h after surgery. MMSE was re-evaluated 6 weeks and whenever possible 3 months after surgery. RESULTS: Thirty-eight patients were enrolled in the study from January until July 2019. The study identified self-sufficiency, multilinguism, and overall health score on the geriatric depression scale, as protectors against PND. No other demographic (age, sex), environmental (solitary/non-solitary housing, professional and physical activities, smoking, alcohol drinking), comorbidity ( antipsychotic drug uptake, diabetic state) and type of surgery (orthopedic, general, genitourinary) influenced the development of PND. Although some factors (surgery type and age) influenced the surgery-induced rise in the circulating IL-6 levels, they did not impact HMGB1. CONCLUSION: Inflammaging, reflected by the greater increment of surgery-induced IL-6 in patients with advanced age, was present. As trauma-induced release of HMGB1 was not similarly affected by age, we surmise that HMGB1, rather than circulating cytokines, is the key driver of the trauma-induced inflammatory cascade leading to PND. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT03805685 .
|
Authors | Sarah Saxena, Christopher Rodts, Vincent Nuyens, Juliette Lazaron, Victoria Sosnowski, Franck Verdonk, Laurence Seidel, Adelin Albert, Jean Boogaerts, Veronique Kruys, Mervyn Maze, Joseph Vamecq |
Journal | BMC anesthesiology
(BMC Anesthesiol)
Vol. 20
Issue 1
Pg. 284
(11 14 2020)
ISSN: 1471-2253 [Electronic] England |
PMID | 33187477
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
|
Topics |
- Aged
- Belgium
(epidemiology)
- Cohort Studies
- Female
- Geriatric Assessment
(methods)
- Humans
- Inflammation
(blood, epidemiology)
- Male
- Middle Aged
- Neurocognitive Disorders
(blood, epidemiology)
- Preoperative Period
- Prospective Studies
- Sedentary Behavior
|