Klausen Henrik Hedegaard, Bodilsen Ann Christine, Petersen Janne, Bandholm Thomas, Haupt Thomas, Sivertsen Ditte Maria, Andersen Ove
Optimized Senior Patient Program, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
Optimized Senior Patient Program, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark.
Mech Ageing Dev. 2017 Jun;164:67-75. doi: 10.1016/j.mad.2017.04.005. Epub 2017 Apr 22.
To investigate whether systemic inflammation in acutely admitted older medical patients (age >65 years) is associated with physical performance and organ dysfunction. Organ dysfunction´s association with physical performance, and whether these associations are mediated by systemic inflammation, was also investigated.
A cross-sectional study in an Emergency Department. Physical performance was assessed by handgrip strength and de Morton Mobility Index (DEMMI), and organ dysfunction by FI-OutRef, the number of standard blood tests outside the reference range. Systemic inflammation was assessed by suPAR, TNFα, and IL-6. Associations were investigated by regression analyses adjusted for age, sex, cognitive impairment, CRP, and VitalPAC Modified Early Warning Score.
A total of 369 patients were evaluated. In adjusted analyses, suPAR and TNFα was associated with both physical performance measures (p<0.001- p=0.004), and IL-6 with handgrip strength (p=0.007). All inflammation biomarkers were associated with FI-OutRef (p<0.001). FI-OutRef was also associated with physical performance (all p<0.001); suPAR being the inflammatory biomarker with the highest impact when adjusting for inflammation.
Inflammatory biomarkers are potentially feasible for systematic assessment of vulnerability. Moreover, suPAR may be an important mediator between organ dysfunction and physical performance.
调查急性收治的老年内科患者（年龄>65岁）的全身炎症是否与身体机能及器官功能障碍相关。同时研究器官功能障碍与身体机能的关联，以及这些关联是否由全身炎症介导。
在急诊科进行的一项横断面研究。通过握力和德莫顿运动指数（DEMMI）评估身体机能，通过FI-OutRef（超出参考范围的标准血液检测项目数量）评估器官功能障碍。通过可溶性尿激酶型纤溶酶原激活物受体（suPAR）、肿瘤坏死因子α（TNFα）和白细胞介素-6（IL-6）评估全身炎症。通过对年龄、性别、认知障碍、C反应蛋白（CRP）和VitalPAC改良早期预警评分进行校正的回归分析来研究相关性。
共评估了369例患者。在校正分析中，suPAR和TNFα与两种身体机能指标均相关（p<0.001 - p = 0.004），IL-6与握力相关（p = 0.007）。所有炎症生物标志物均与FI-OutRef相关（p<0.001）。FI-OutRef也与身体机能相关（所有p<0.001）；在校正炎症因素后，suPAR是影响最大的炎症生物标志物。
炎症生物标志物对于系统评估脆弱性可能是可行的。此外，suPAR可能是器官功能障碍与身体机能之间的重要介导因素。
