TY  - BOOK
AU  - Goyal, Munish
TI  - Age-related differences in biomarkers of acute inflammation during hospitalization for sepsis
SN  - 1073-2322
KW  - *Inflammation Mediators/bl [Blood]
KW  - *Sepsis/co [Complications]
KW  - *Systemic Inflammatory Response Syndrome/di [Diagnosis]
KW  - Adolescent
KW  - Adult
KW  - Age Distribution
KW  - Age Factors
KW  - Aged
KW  - Aged, 80 and over
KW  - Biological Markers/bl [Blood]
KW  - Female
KW  - Hospitalization
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Prospective Studies
KW  - Sensitivity and Specificity
KW  - Severity of Illness Index
KW  - Systemic Inflammatory Response Syndrome/mi [Microbiology]
KW  - Young Adult
KW  - MedStar Washington Hospital Center
KW  - Emergency Medicine
N1  - Available online through MWHC library: 2002 - present
N2  - The authors aimed to evaluate age-related differences in inflammation biomarkers during the first 72 h of hospitalization for sepsis. This was a secondary analysis of a prospective observational cohort of adult patients (n = 855) from 10 urban academic emergency departments with confirmed infection and two or more systemic inflammatory response syndrome criteria. Six inflammation-related biomarkers were analyzed-chemokine (CC-motif) ligand-23, C-reactive protein, interleukin-1 receptor antagonist, neutrophil gelatinase-associated lipocalin (NGAL), peptidoglycan recognition protein, and tumor necrosis factor receptor-1a (TNFR-1a)-measured at presentation and 3, 6, 12, 24, 48, or 72 h later. The median age was 56 (interquartile range, 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 to 34 years had severe sepsis or septic shock compared with 71% for those aged 65 years or older (P < 0.001). In longitudinal models adjusting for demographics, comorbidities, and infection source, older age was associated with higher baseline values for chemokine (CC-motif) ligand-23, interleukin-1 receptor antagonist, NGAL, and TNFR-1a (all P < 0.05). However, older adults had higher mean values during the entire 72-h period only for NGAL and TNFR-1a and higher final 72-h values only for TNFR-1a. Adjustment or stratification by sepsis severity did not 150318 the age-inflammation associations. Although 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 h of hospitalization
UR  - http://dx.doi.org/10.1097/SHK.0000000000000182
ER  -