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Older patients are immunocompromised by cytokine depletion and loss of innate immune function after hip fracture surgery

Sutherland, Alasdair G., Cook, Alistair, Miller, Clare, Duncan, Linda, Yuecel, Raif, Heys, Steven D., Hutchison, James D. and Liversidge, Janet 2015, Older patients are immunocompromised by cytokine depletion and loss of innate immune function after hip fracture surgery, Geriatric orthopaedic surgery & rehabilitation, vol. 6, no. 4, pp. 295-302, doi: 10.1177/2151458515605564.

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Title Older patients are immunocompromised by cytokine depletion and loss of innate immune function after hip fracture surgery
Author(s) Sutherland, Alasdair G.
Cook, Alistair
Miller, Clare
Duncan, Linda
Yuecel, Raif
Heys, Steven D.
Hutchison, James D.
Liversidge, Janet
Journal name Geriatric orthopaedic surgery & rehabilitation
Volume number 6
Issue number 4
Start page 295
End page 302
Total pages 8
Publisher Sage
Place of publication London , Eng.
Publication date 2015-12
ISSN 2151-4585
Keyword(s) cellular immunology
monocytes
innate immunity
cytokines
T cells
Summary PURPOSE/INTRODUCTION: We have examined the immune status of elderly patients who underwent surgery for a hip fracture, an injury associated with poor postoperative outcomes, to identify specific immune defects. METHODS: In a cohort observational study, 16 patients undergoing surgery for hip fractures had immune function evaluation prior to surgery, and then at 3 and 7 days postoperatively, using flow cytometry for phenotype and for monocyte and granulocyte phagocytic function and respiratory burst. Serum samples were stored and batch analyzed using a human cytokine 25-plex panel. RESULTS: We report significant loss of innate immune function, related specifically to reduced granulocyte numbers by day 7 (P < .0001, flow cytometry; P < .05 white blood cells), and although granulocyte ability to take up opsonized Escherichia coli was increased (P < .05), the ability of those cells to generate a respiratory burst was reduced at days 3 and 7 (P < .05). Monocyte respiratory burst was also significantly reduced (P < .05). Serum cytokine levels indicated very poor T-cell function. CONCLUSION: We have demonstrated that the antimicrobial immune response is profoundly reduced after surgery in elderly patients with hip fractures. The effect was sustained up to 7 days postoperatively, identifying these patients as particularly vulnerable to bacterial infections.
Language eng
DOI 10.1177/2151458515605564
Field of Research 110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 920502 Health Related to Ageing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, The Author(s)
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080631

Document type: Journal Article
Collection: School of Medicine
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