Cortisol,interleukins and S100B in delirium in the elderly |
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| Authors: | Barbara C. van Munster Peter H. Bisschop Aeilko H. Zwinderman Johanna C. Korevaar Erik Endert W. Joost Wiersinga Hannah E. van Oosten J. Carel Goslings Sophia E.J.A. de Rooij |
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| Affiliation: | 1. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands;2. Department of Medicine, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands;3. Department of Clinical Chemistry, Laboratory of Endocrinology and Radiochemistry, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands;4. Trauma Unit Department Surgery, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands |
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| Abstract: | In independent studies delirium was associated with higher levels of cortisol, interleukin(IL)s, and S100B. The aim of this study was to simultaneously compare cortisol, IL-6, IL-8, and S100B levels in patients aged 65 years and older admitted for hip fracture surgery with and without delirium. Cortisol, IL-6, IL-8, and S100B were assayed in repeated blood samples. 120 patients (mean age 84 years, 62 patients with delirium) were included. Highest levels of IL-8 (27.1, 95% Confidence Interval (CI): 13.6–53.1 pg/ml) and cortisol (666, 95% CI: 475–859 nmol/L) were before delirium, but of IL-6 (84.3, 95% CI: 46.5–151.4 pg/mL) and S100B (0.18, 95% CI: 0.12–0.24 μg/L) during delirium. In multivariable analysis cortisol, LogIL-6, and LogS100B were significantly associated with delirium, but adjusted for pre-existing cognitive impairment, only LogS100B remained significantly associated. Cortisol, IL-6 and S100B may have a role in the pathogenesis of delirium, but S100B is the strongest independent marker. |
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| Keywords: | Cognitive impairment Cortisol Cytokines Delirium Inflammation Interleukin 6 Interleukin 8 S100B |
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