George, Michael and Mukherjee, Rajarshi
(2023)
Prognostic Serum Biomarkers of Inflammaging in Patients Undergoing Emergency Laparotomy.
JOURNAL OF PERSONALIZED MEDICINE, 13 (5).
769-.
Abstract
Surgeons are increasingly faced with an ageing and frail patient population. There is a significant absence of biomarkers capable of risk stratifying patients undergoing emergency laparotomy. Inflammaging describes a state of chronic inflammation associated with ageing and frailty that may predict worse outcomes after surgery. This retrospective observational study evaluated pre-morbid inflammatory markers in the prognostication of older adult patients undergoing emergency laparotomy. Patients aged ≥65 years undergoing surgery between 1 April 2017 and 1 April 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) datapoints were captured. Pre-operative risk stratification scores and post-operative outcomes were recorded using the National Emergency Laparotomy Audit (NELA) database. A cohort of 196 patients was included: 57.7% were female, median age 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 (<i>p</i> < 0.05). Pre-admission ESR ≥ 16 and LC ≥ 4.1 were significantly associated with a longer critical care stay (<i>p</i> < 0.05); no statistical significance was observed with CRP, WCC and NC in predicting adverse outcomes. We found that an elevated pre-morbid ESR and LC identifies a potential inflammaging cohort that demonstrates worse outcomes following emergency laparotomy. The prognostication of older adult surgical patients remains a challenge and represents an area of research deserving of future attention.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | biomarkers, emergency, frailty, inflammaging, inflammation, laparotomy, older adult, outcomes, prognosis, surgery |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 02 Feb 2024 10:29 |
| Last Modified: | 02 Feb 2024 10:29 |
| DOI: | 10.3390/jpm13050769 |
| Open Access URL: | https://doi.org/10.3390/jpm13050769 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3178304 |
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