Study of senile astheny markers against the background of acute inflammatory process in elderly and senile patients in emergency abdominal surgery

Abstract

The aim of our work was to determine the influence of the acute inflammatory process on the diagnostic value of markers of senile asthenia in emergency abdominal surgery. Material and methods. The basis of the work included 92 (100.0 %) patients, the average age in the entire group was 72.0 ± 2.3 years. All patients were divided into three groups: group A – 32 (34.8 %) patients with acute surgical pathology and confirmed senile asthenia syndrome. The group included 15 (16.3 %) patients with acute cholecystitis and 17 (18.5 %) with perforation of a gastric or duodenal ulcer. Group B included 30 (32.6 %) people with acute surgical pathology, which was statistically comparable in terms of the number of surgical diagnoses to group A, but without asthenia. To determine the reliability of the inflammatory process influence on markers of senile asthenia, we formed group C – 30 (32.6 %) patients without acute surgical pathology, but with the syndrome of senile asthenia. Based on the literature analysis, we selected markers of malnutrition syndrome: total protein, albumin and cholesterol levels, and the marker of sarcopenia – somatotropic hormone. Results. Based on the comparison of the obtained results, we found a decrease in the level of total protein in groups A and C, which was not significantly different, p = 0.2519, U = 372.0. Whereas when comparing groups, A and B, a significant decrease was found in the group of patients with asthenia (A) – p = 0.0009, U = 224.0. The same data were obtained when comparing the level of albumin; in groups A and C the level of albumin was reduced but did not differ significantly between groups – p = 0.1932, U = 361.5, whereas comparing groups with senile asthenia syndrome (group A) and without it (group B), a significant difference was found – p = 0.0072, U = 268.0. When determining the cholesterol level, we did not find a significant difference between the groups with asthenia (A and C) – p = 0.0614, U = 323.0, as well as between the groups with asthenia and without asthenia with acute inflammation (A and B) – p = 0.01646. It was determined that the level of somatotropic hormone in the groups with asthenia (A and C) was equally low – p = 0.9646, U = 466.5, while when comparing the group with and without asthenia (A and B), a significant decrease in this hormone was found in group A – p = 0.0030, U = 248.5. Conclusions. The absence of acute inflammatory process influence on the diagnostic value of the studied markers of senile asthenia in the groups was determined. When comparing the results between group A (acute surgical pathology + senile asthenia syndrome) and group B (acute surgical pathology without senile asthenia syndrome), a significant decrease in the level of total protein, albumin, and somatotropic hormone was revealed, p = 0.0009, p = 0.0072 and p = 0.0030, respectively, while when comparing groups with asthenia (A and C) no significant difference was found, p = 0.2519, p = 0.1932 and p = 0.9646. The level of total cholesterol cannot be used as a marker for the diagnosis of senile asthenia in emergency abdominal surgery, as there are a significant number of factors that directly affect the results of the diagnosis. Comparison of the results of the groups with asthenia and without asthenia on the background of acute inflammatory process (A and B) showed no significant difference, p = 0.1646. The same negative results were obtained when evaluating groups with asthenia (A and C) – p = 0.0614.

Keywords

• asthenia
• old age
• frailty
• clinical marker