Abstract
Objective
Pathophysiological mechanisms leading to delirium are not clear. Age is a known risk factor and hypothesised to be accompanied by a low‐grade inflammatory state. Previous studies have shown an association between delirium and circulating proinflammatory markers in acutely ill and postoperative patients. In light of the ageing/inflammation theory, we investigated the association of these markers with delirium in not acutely ill, elderly patients.
Methods
In a prospective nested case‐control study levels of C‐reactive protein (CRP), interleukin 6 (Il‐6), insulin growth factor 1 (IGF‐1) were measured pre‐operatively in elderly patients admitted for hip‐surgery. These levels were compared between patients who later developed a post‐operative delirium and patients who did not. Patients were matched for age and disease severity.
Results
Eighteen patients who developed delirium post‐operatively were matched with 50 controls. Median APACHE‐scores were below 16 in both groups. Pre‐operative serum concentrations of CRP, Il‐6 and IGF‐1 did not differ between groups. IL‐6 levels were associated with a measure of cognitive impairment.
Conclusion
In the present study no relationship was found between levels of pre‐operative circulating pro‐inflammatory markers and post‐operative delirium in elderly patients, who were free from acute or severe disease. Copyright © 2008 John Wiley & Sons, Ltd.