Reference : Serum IL-6 and IGF-1 improve clinical prediction of functional decline after hospital...
Scientific journals : Article
Human health sciences : Endocrinology, metabolism & nutrition
Human health sciences : Immunology & infectious disease
Human health sciences : Geriatrics
Serum IL-6 and IGF-1 improve clinical prediction of functional decline after hospitalization in older patients
de Saint-Hubert, Marie [Cliniques universitaires Mont-Godinne UCL > Département de Gériatrie > > >]
Jamart, Jacques [Cliniques universitaires Mont-Godinne UCL > Département de Biostatistique > > >]
Morrhaye, Gabriel [Université de Liège - ULiège > Centre d'Immunologie > > >]
Martens, Henri mailto [Université de Liège - ULiège > > Centre d'immunologie >]
Geenen, Vincent mailto [Université de Liège - ULiège > > Centre d'immunologie >]
Duy Vo, Thy Kim [Facultés Universitaires Notre-Dame de la Paix - Namur - FUNDP > Laboratoire de Biochimie et de Biologie Cellulaire > > >]
Toussaint, Olivier [Facultés Universitaires Notre-Dame de la Paix - Namur - FUNDP > Département de Biochimie et Biologie Cellulaire > > >]
Swine, Christian [Cliniques universitaires Mont-Godinne UCL > Département de Gériatrie > > >]
Aging Clinical & Experimental Research
Editrice Kurtis SRL
Yes (verified by ORBi)
[en] Background and aims: Although inflammatory and hormonal markers have been associated
with further functional adverse outcomes in community-dwelling seniors, these markers have not been studied from this perspective in acutely ill older patients. This prospective study was designed to determine whether biological markers can improve the predictive value of a clinical screening tool to assess the risk of functional decline in hospitalized older patients.
Methods: Patients aged 75 years and over admitted for hip fracture, acute heart failure or infection (n=118) were recruited. The clinical screening tool SHERPA was filled in on admission, with concomitant measurement of interleukin-6 (IL-6), insulin-like growth
factor 1 (IGF-1), C-reactive protein (CRP), white blood cells, urea, albumin, pre-albumin and total cholesterol. Functional decline was defined as a decrease of one point in the activities of daily living scale between pre-admission and 3-month post-discharge status. We
compared the discrimination calibration of SHERPA vs SHERPA+, a logistic regression model including SHERPA and selected biomarkers. Results: Three months after discharge, functional decline had occurred in 46 patients. IL-6 and IGF-1 were selected, since their levels were significantly different between decliners and non-decliners, and were included in the new logistic regression model SHERPA+. Areas under the ROC curve [95% CI] for functional decline prediction were 0.73 [0.63-0.81] for SHERPA vs 0.79 [0.69-0.86] for SHERPA+ (p=0.14). However, SHERPA+ was better calibrated, as the average predicted
risk of functional decline within subgroups matched the proportion which actually underwent
functional decline (Brier score=0.185). Since functional decline was higher in patients with hip fracture, the SHERPA+ model was challenged by including the diagnosis. Only SHERPA, IGF-1 and diagnosis were significantly associated with functional decline. Conclusions:
Selected biological markers may marginally improve the clinical prediction of post-discharge
functional decline in hospitalized patients, and may allow to stratify them appropriately. The predictive value of these biomarkers is not fully independent of disease status. Further studies are needed to confirm these results in a cohort representative of older patients admitted through the emergency department. (Aging Clin Exp Res 2011; 23: 106-111)
Région wallonne : Direction générale des Technologies, de la Recherche et de l'Energie - DGTRE ; Fonds de la Recherche Scientifique (Communauté française de Belgique) - F.R.S.-FNRS
Researchers ; Professionals

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