Accelerated cytokine responses of elderly patients result in a significant increase of systemic inflammatory response syndrome and postoperative complications following gastrointestinal surgery

Objectives: We clarified a distinctive feature of response to surgical stress in elderly patients compared to nonelderly patients. Subjects: Two hundred and ninety-two consecutive patients received elective gastrointestinal surgery. Patients were analyzed for physiological status, cytokine levels, surgical stress parameters and postoperative status of SIRS and complications. Cytokine responses according to patient''s age: Plasma levels of interleukin 6 (IL-6) fluctuated in higher concentrations in elderly patients. Peak plasma levels of IL-6 were significantly high in patients aged over 75 years in total gastrectomy, over 65 years in pancreaticoduodenectomy and over 60 years in major hepatectomy. Mechanisms of hypercytokinemia in elderly patients: Renal dysfunction caused hypercytokinemia in elderly patients. Hypercytokinemia and SIRS: SIRS was more frequently encountered and continued for a long time in elderly patients, giving us an early sign of postoperative complications. Conclusions: In order to prevent postoperative complications in elderly patients, we must shorten status of SIRS due to excessive hypercytokinemia. [Copyright &y& Elsevier]