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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on October 6, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/glp145
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Surgery-Induced Inflammation in Relation to Age, Muscle Endurance, and Self-Perceived Fatigue

I. Bautmans1,2,3, R. Njemini1,2, J. De Backer4, E. De Waele4 and T. Mets1,2,3

1 Frailty in Ageing Research Department
2 Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan, Belgium
3 Geriatrics Department
4 Surgery Department, Universitair Ziekenhuis Brussel, Belgium

Address correspondence to Tony Mets, PhD, MD, Geriatrics Department, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium. Email: tony.mets{at}vub.ac.be


  Abstract

Background: Elective abdominal surgery can be considered as a model for an important acute inflammatory trigger in human participants. The aim of the study was to explore the effect of surgery-induced inflammation on muscle strength, endurance, and self-perceived fatigue and its relation with age.

Methods: Sixty-six elective abdominal surgery patients aged 24–91 years were assessed before and at the second and fourth day after surgical intervention. Outcome parameters were grip strength, muscle endurance, fatigue subscale of the Profile of Mood State and visual analog scale for pain, and the circulating inflammatory mediators C-reactive protein, interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-{alpha}).

Results: All parameters worsened postoperatively (p < .01) and remained significantly (p < .05) worse until the fourth day postsurgery, except for TNF-{alpha} (no significant change). Older age was related to higher surgery-induced IL-6 levels at the second (p < .05) and fourth postoperative (p < .01) day and to worse self-perceived fatigue and muscle endurance (both p < .05) at the fourth postoperative day. Higher pain levels at the second day following surgery was related to more self-perceived fatigue (p < .05). Worsening muscle endurance following surgery was significantly related to higher IL-6 release following surgery (p < .01) and self-perceived fatigue (p < .05) at the fourth day following the intervention. Age and surgery-induced increase in circulating IL-6 at Day 4 postsurgery was highest in patients showing both worsened muscle endurance and self-perceived fatigue (p < .05).

Conclusions: Surgery-induced inflammation is related to reduced muscle endurance and the sensation of fatigue. Elderly patients suffer from a higher impact of surgery on muscle endurance.

Keywords Elderly; Surgery; Acute-phase reaction; Muscle fatigue; Grip strength

Received: June 21, 2009; Accepted: August 28, 2009

Decision Editor: Luigi Ferrucci, MD, PhD


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