CHEN Xiangxu 1,2,3,4 , ZHU Huanyi 1,2,3,4 , WU Wei 1,2,3,4 , TIAN Chuwei 1,2,3,4 , SHI Liu 1,2,3,4 , FAN Wenbin 1,2,3,4 , ZHANG Cheng 1,2,3,4 , LI Yingjuan 3,4,5 , CHEN Hui 1,2,3,4 , GAO Wei 3,4,5 , RUI Yunfeng 1,2,3,4
  • 1. Trauma Center, Department of Orthopaedic Surgery, Zhongda Hospital Affiliated to Southeast University, Nanjing Jiangsu, 210009, P. R. China;
  • 2. Institute of Trauma Orthopaedics, Southeast University, Nanjing Jiangsu, 210009, P. R. China;
  • 3. Multidisciplinary Team for Geriatric Hip Fracture, Zhongda Hospital Affiliated to Southeast University, Nanjing Jiangsu, 210009, P. R. China;
  • 4. School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P. R. China;
  • 5. Department of Geriatrics, Zhongda Hospital Affiliated to Southeast University, Nanjing Jiangsu, 210009, P. R. China;
RUI Yunfeng, Email: ruiyunfeng@126.com
Osteoporosis; male; intertrochanteric fracture; fracture healing; interleukin 6
10.7507/1002-1892.202405057
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Objective  To investigate the perioperative changes in serum interleukin 6 (IL-6) levels in elderly male patients with intertrochanteric fractures, and provide evidence for inflammatory control in this patient population. Methods  The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed, including 25 non-osteoporosis patients (T value>-2.5, group A) and 15 osteoporosis patients (T value≤-2.5, group B). In addition, 40 healthy men aged more than 60 years old were included as controls (group C) according to the age matching rule. There was no significant difference in age, smoking history, drinking history, body mass index, complications (hypertension and diabetes), alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine and total protein among the 3 groups (P>0.05). Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1, 3, 5, and 7. IL-6 levels were measured using ELISA assay. Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B. Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B. Results  Preoperative IL-6 levels were significantly higher in groups A and B compared to group C (P<0.05), with group B being significantly higher than group A (P<0.05). In groups A and B, IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased, approaching preoperative levels by postoperative day 7. IL-6 levels in group B were significantly higher than those in group A at all postoperative time points (P<0.05). Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B (P<0.05). Complications occurred in 4 patients (16.0%) in group A, including 2 cases of pulmonary infection, 1 case of urinary tract infection, and 1 case of heart failure, and in 3 patients (20.0%) in group B, including 2 cases of pulmonary infection and 1 case of gastrointestinal bleeding. There was no significant difference in the incidence of complications between the two groups (χ2=0.104, P=0.747). There were 2 cases (8.0%) and 4 cases (26.7%) died within 1 year after operation in groups A and B, respectively, and there was no significant difference in mortality between the two groups (χ2=2.562, P=0.109). Conclusion  Serum IL-6 levels significantly increase in the early postoperative period in elderly male patients with intertrochanteric fractures, especially in those with osteoporosis. Monitoring the inflammatory state and promptly controlling the inflammatory response during the perioperative period, may reduce complications and improve postoperative survival in this patient population.