George, M.; Mukherjee, R. Prognostic Serum Biomarkers of Inflammaging in Patients Undergoing Emergency Laparotomy. J. Pers. Med.2023, 13, 769.
George, M.; Mukherjee, R. Prognostic Serum Biomarkers of Inflammaging in Patients Undergoing Emergency Laparotomy. J. Pers. Med. 2023, 13, 769.
George, M.; Mukherjee, R. Prognostic Serum Biomarkers of Inflammaging in Patients Undergoing Emergency Laparotomy. J. Pers. Med.2023, 13, 769.
George, M.; Mukherjee, R. Prognostic Serum Biomarkers of Inflammaging in Patients Undergoing Emergency Laparotomy. J. Pers. Med. 2023, 13, 769.
Abstract
Surgeons are increasingly faced with a challenging, ageing and frail patient population. A significant absence of biomarkers to stratify outcomes of patients undergoing emergency laparotomy exists. Inflammageing describes a state of chronic inflammation associated with ageing and frailty and may predict worse outcomes. This retrospective observational study evaluated pre-morbid inflammatory markers in the prognostication of elderly patients undergoing emergency laparotomy. Patients aged ≥65 years undergoing surgery between 01/04/2017 – 01/04/2022 were identified. Pre-admission and acute C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total white cell count (WCC), neutrophil count (NC) and lymphocyte count (LC) data points were captured. Pre-operative risk stratification scores and postoperative outcomes were recorded using the National Emergency Laparotomy Audit (NELA) database. A cohort of 196 patients was included: 57.7% were female, median age of 74.5 years. High-risk (NELA risk of mortality ≥5%) and frail (clinical frailty scale ≥4) patients experienced a significantly longer hospital and critical care stay (p<0.05). Pre-admission ESR ≥16 and LC ≥4.1 were significantly associated with a longer critical care stay (p<0.05), however, no statistical significance was observed with CRP, WCC and NC in predicting adverse outcomes. We found an elevated pre-morbid ESR and LC identifies a potential inflammageing cohort that demonstrate worse outcomes following emergency laparotomy. The prognostication of elderly surgical patients remains a challenge and represents an area of research deserving of future attention.
Keywords
Frailty; elderly; inflammageing; inflammation; biomarkers; prognosis; outcomes; emergency; laparotomy; surgery
Subject
Medicine and Pharmacology, Surgery
Copyright:
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