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Low plasma levels of IGF-1 and IL-1RA with high plasma levels of IFN-γ as prognostic factor for mortality in hospitalized geriatric patients with delirium

Abstract

ABSTRACT

Background: Delirium is common and serious problem with high morbidity and mortality, especially in geriatric patients. Decrease in the number of neuroprotective factors (IGF-I and IL-1RA) and increase in IFN-γ had been correlated with the incidence of delirium. This study aims to understand whether these markers can be used as predictors for mortality in geriatric patients with delirium in an effort to prevent the adverse events of delirium.

Methods: In this observational analytic study with prospective cohort design carried out in the Geriatric Installation care room at Sanglah General Hospital in Denpasar in 2018, 76 samples were examined for their IGF-1, IL-1RA, IFN-γ plasma levels. Patients were then followed during their hospital stay until they were declared cured or died due to delirium or its complications. The relationship between each group and mortality rate were then analyzed using univariate, bivariate and multivariate analysis.

Results: In this study, median was used as the cutoff point for IGF-1 levels [21.38 (0.00-91.07)], IL-1RA levels [2,491.48 (193,44-6720,13)] and IFN-γ [194.29 (0.00-2200.96)]. In multivariate analysis, low plasma levels of IGF-1 (HR= 4.12 [95% CI: 1,458 - 11,642, p=0.008]) and IL-1RA (HR=2.91 [95 % CI: 1.037 - 8.154, p= 0.043]) proved to be an independent factor in the occurrence of death in geriatric patients with delirium. However, IFN- γ failed to show any correlations.

Conclusion: Both low plasma levels of IGF-1 and IL-1RA can be used as predictors for mortality in geriatric patients with delirium.

References

  1. Lewis LM, Han J, Eden S. Unrecognized delirium in ED geriatric patients. Am J Emerg Med. 2008:13: 142-5. DOI: 10.1016/0735-6757(95)90080-2
  2. Soejono CH. Sindrom Delirium Akut. Dalam: Soejono, Setiati S, Nastrun MWS (editor). Pedoman Pengelolaan Pasien Geriatri untuk Dokter dan Perawat. Jakarta. PIP-IPD FKUI. 2000:h.77-81.
  3. Maldonado JR. Neuropathogenesis of Delirium: Review of Current Etiologic Theories and Common Pathway. Am J Geriatr Psychiatri. 2013: 21(12): 1190-1222. DOI: 10.1016/j.jagp.2013.09.005
  4. Adamis D, Lunn M, Martin FC, Treolar A, Gregson, N, Hamilton G. Cytokines and IGF-I in delirious and non-delirious acutely ill older medical inpatients. Age and Ageing. 2009: 38(3): 326-332. DOI: 10.1093/ ageing/afp014
  5. Boogaard M, Kox M, Quinn KL, Achterberg T, Hoeven JG, Schoonhoven L. Biomarkers associated with delirium in critically ill patients and their relation with long term subjective cognitive dysfunction; indications for different pathway governing delirium in inflamed and noninflamed patients. Critical Care. 2011: 15(6): R297. DOI: 10.1186/cc10598
  6. Morandi A, Gunther ML, Pandharipande PP, Jackson, JC, Thompson JL, Shintani AK. Insulin-like growth factor-1 and delirium in critically ill mechanically ventilated patients: a preliminary investigation. International Psychogeriatrics. 2011: 23(7): 1175-1181. DOI: 10.1017/S1041610210002486
  7. Dasgupta M, Brymer C. Prognosis of delirium in hospitalized elderly: worse than we thought. Int J Geriatr Psychiatry. 2014: 29: 497-505. DOI: 10.1002/gps.4032
  8. Jackson TA, Wilson D, Richardson S, Lord JM. Predicting outcome in older hospital patients with delirium: a systematic literature review. Int J Geriatr Psychiatry. 2016: 31:396-403. DOI: 10.1002/gps.4344
  9. Ripper CJ, Aleman MR, Ros R, Aguilera S, Reimers EG, Espelosin, E. Prognostic value of acute delirium recovery in older adults. Geriatr Gerontol Int. 2016: 11(5): 1-7. DOI: 10.1111/ggi.12842
  10. Maggio M, Vita FD, Lauretani F, Butto V, Bondi G, Cattabiani C, Nouvenne A, Meschi T, Dall’Aglio E, Ceda GP. IGF-1, the Cross Road of the Nutritional, Inflammatory and Hormonal Pathways to Frailty. Nutrients. 2013: 5: 4184-4205. DOI: 10.3390/nu5104184
  11. Torres I, Aleman D. Toward a Comprehensive Neurobiology of IGF-I. Wiley InterScience. 2010: 384-396. DOI: 10.1002/dneu.20778.

How to Cite

Astika, I. N., Widiana, I. G. R., Suastika, K., & Kuswardhani, R. T. (2019). Low plasma levels of IGF-1 and IL-1RA with high plasma levels of IFN-γ as prognostic factor for mortality in hospitalized geriatric patients with delirium. Bali Medical Journal, 8(2), 633–636. https://doi.org/10.15562/bmj.v%vi%i.1469

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I Nyoman Astika
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I Gde Raka Widiana
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Ketut Suastika
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RA Tuty Kuswardhani
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