Serum levels of IL-6 and IL-10 on admission correlate with complications in elderly patients with hip fracture

García-Álvarez, Felicito ; Chueca-Marco, Álvaro (Universidad de Zaragoza) ; Martínez-Lostao, Luis (Universidad de Zaragoza) ; Aso-Gonzalvo, María ; Estella-Nonay, Rubén (Universidad de Zaragoza) ; Albareda, Jorge (Universidad de Zaragoza)

Resumen: Ageing may cause a progressive pro-inflammatory environment and alter functionality of different immune-cell populations. The aim of the present study is to examine the influence of certain serum immunological parameters on hospitalization stay and complications in patients who have suffered a hip fracture.

Patients and methods
A prospective study was carried out with 87 patients (63 women) presenting with either trochanteric femoral fracture or Garden IV displaced subcapital fracture. The average age was 84.43 ± 9, ranging from 65 to 104 years old. Data regarding different comorbidities were recorded at the time of arrival. The morning after patient's admission peripheral blood samples were obtained and a series of immunological parameters were determined: leukocyte formula, platelets count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), IL-6 and IL-10 levels, T-lymphocytes count, number of cells/mm3 and percentages of CD3, CD4, CD8, CD3-/CD16/56+ (NK cells), and CD3-/CD19+ (B cells).

Results
IL-6 serum levels presented a positive and significant correlation with higher levels of CRP (p < 0.001), IL-10 (p = 0.002), and higher percentages of NK CD56+ cells (p = 0.046). IL-6 serum levels at hospitalization presented a positive and significant correlation with a longer hospitalization stay (p = 0.037). Hospitalization increased by 0.231 days for every 1 pg/mL above the IL-6 mean value (40.43 pg/mL). Lower serum IL-10 levels on admission were associated with the appearance of symptomatic urinary tract infection during hospitalization (p = 0.032). Higher number of CD19+ cells/mm3 presented a significant relationship with pneumonia (p = 0.018) and symptomatic urinary tract infection (p = 0.0019).

Conclusions
IL-6 serum levels on admission showed a positive and significant correlation with a longer hospitalization stay in elderly patients presenting with hip fracture. Lower levels of IL-10 in peripheral blood on admission were associated with symptomatic urinary tract infections. A higher number of CD19+ cells/mm³ was significantly associated with pneumonia and symptomatic urinary tract infection. These immunological variables on admission may serve as risk indicators of complications during hospitalization.

Idioma: Inglés

DOI: 10.1016/j.injury.2024.111736

Año: 2024

Publicado en: Injury (2024), 111736 [7 pp.]
ISSN: 0020-1383

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Traumatología y Ortopedia (Dpto. Cirugía)
Área (Departamento): Área Inmunología (Dpto. Microb.Ped.Radio.Sal.Pú.)