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Observational Study
. 2017 Dec 19;18(1):541.
doi: 10.1186/s12891-017-1900-y.

Comparison of cortisol and inflammatory response between aged and middle-aged patients undergoing total hip arthroplasty: a prospective observational study

Jian Zhong  1 , Hai-Bo Si  1 , Yi Zeng  1 , Jing Yang  1 , Zong-Ke Zhou  1 , Peng-de Kang  1 , Fu-Xing Pei  1 , Bin Shen  2
Affiliations
Observational Study

Comparison of cortisol and inflammatory response between aged and middle-aged patients undergoing total hip arthroplasty: a prospective observational study

Jian Zhong et al. BMC Musculoskelet Disord. .

Abstract

Background: To investigate the differences in the perioperative serum cortisol, C-reactive protein (CRP) and interleukin-6 (IL-6) levels between aged and middle-aged patients undergoing total hip arthroplasty (THA).

Methods: Sixty patients (30 aged and 30 middle-aged) undergoing THA for osteoarthritis between August 2016 and January 2017 participated in this study. Blood samples were collected preoperatively and at 6 hours, 24 hours and 3 days after surgery to measure the cortisol, CRP and IL-6 concentrations. The clinical outcomes were assessed using the visual analogue scale (VAS) pain score and Harris hip score (HHS).

Results: No significant differences were found between the two groups before the operation in the cortisol, IL-6 and CRP levels; the VAS score; or the HHS. Cortisol was significantly lower at 6 hours after surgery in the aged group than in the middle-aged group (P < 0.05). IL-6 at 6 and 24 hours after surgery, CRP at 3 days after surgery and the VAS score at 6 and 24 hours after surgery in the aged group were significantly higher than those in the middle-aged group (P < 0.05). In the aged group, weak correlations were found between the cortisol concentration 6 hours after THA and the IL-6 level 24 hours after THA (r = -0.37, P = 0.04) and between the IL-6 level 6 hours after THA and the VAS score 24 hours after THA (r = 0.42, P = 0.02).

Conclusion: Aged patients showed lower cortisol levels at 6 hours after surgery and higher IL-6 levels at 6 and 24 hours after surgery than middle-aged patients undergoing THA.

Keywords: Aged; Arthroplasty; Cortisol; Hip; Middle aged.

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Conflict of interest statement

Ethics approval and consent to participate

This study has been approved by the Institutional Review Board at the West China Hospital, Sichuan University. Each author certifies that all investigations were conducted in accordance with ethical principles. All participants involved in the study gave their informed consent and signed and informed consent form.

Consent for publication

Not Applicable

Competing interests

The authors announce that they do not have any competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The chart of patient flow in the study
Fig. 2
Fig. 2
The stress response (cortisol, a) and inflammatory response (IL-6 and CRP, b and c) of middle-aged and aged patients preoperatively and at 6 h, 24 h and 3 days after THA. Asterisk (*) means the difference between the two groups reached statistical significance (P < 0.05)
Fig. 3
Fig. 3
a The pain assessment (VAS) of middle-aged and aged patients preoperatively and at 6, 24, 48 and 72 h after THA. b The function assessment (HHS) of middle-aged and aged patients preoperatively and at 3 months after THA. *: P < 0.05 comparing the two age groups
Fig. 4
Fig. 4
a Correlation between cortisol at 6 h after THA and IL-6 at 24 h after THA in the aged group. b Correlation between IL-6 at 6 h after THA and VAS at 24 h after THA in the aged group. c Correlation between CRP at 6 h after THA and VAS at 24 h after THA in the middle-aged group
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