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Predicting Long-term Cognitive Dysfunction in Survivors of Critical Illness with Plasma Inflammatory Markers: a Retrospective Cohort Study

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Abstract

Persistent inflammation in intensive care unit (ICU) survivors is associated with higher long-term mortality and poorer mobility. However, it is unknown if inflammatory markers are associated with other dysfunctions observed in survivors of critical illness. Thus, it was investigated if plasma levels of interleukin (IL)-6 and IL-10 at hospital discharge were associated with long-term functional and cognitive performance after ICU discharge. Adult patients admitted for > 48 h to a 20-bed mixed ICU in a University Hospital had blood collected within 48 h before hospital discharge to measure IL-6 and IL-10 levels. After a median time of 48 months, cognitive status was determined by the Mini-Mental State Examination (MMSE), and functional status was determined by the Barthel Index. Patients at the higher 25th percentile of both IL-6 and IL-10 had a worse long-term cognitive performance, but not worse functional status, even when adjusted for confounders after long-term follow-up. In conclusion, elevated circulating IL-6 and IL-10 concentrations at hospital discharge were associated with long-term cognitive dysfunction in ICU survivors.

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Abbreviations

IL:

interleukin

ICU:

intensive care unit

CAP:

community-acquired pneumonia

RASS:

Richmond Agitation and Sedation Scale

MMSE:

Mini-Mental State Examination

BADL:

basic activities of daily life

ACE-27:

Adult Comorbidity Evaluation-27

APACHE:

acute physiologic assessment and chronic health evaluation

AD:

Alzheimer’s disease

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Funding

Supported by grants from the National Council for Scientific and Technological Development (CNPq), NENASC project (PRONEX program CNPq/FAPESC), PPSUS-FAPESC, and Universidade do Extremo Sul Catarinense.

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Author notes

  1. Marcus Maciel and Sabrina Ronconi Benedet contributed equally to this work.

Authors and Affiliations

  1. Intensive Care Unit, Hospital Universitário, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil

    Marcus Maciel, Elizabeth Buss Lunardelli, Henrique Delziovo & Rayane Lima Domingues

  2. Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina, Av Universitária, 1105, Criciúma, SC, 88806000, Brazil

    Sabrina Ronconi Benedet, Francieli Vuolo, Cristiane Damiani Tomasi, Cristiane Ritter & Felipe Dal-Pizzol

  3. Center of Excellence in Applied Neurosciences of Santa Catarina (NENASC), Graduate Program in Medical Sciences, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil

    Roger Walz & Felipe Dal-Pizzol

  4. Intensive Care Unit, Hospital São José, Criciúma, SC, Brazil

    Cristiane Ritter & Felipe Dal-Pizzol

Authors
  1. Marcus Maciel
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  2. Sabrina Ronconi Benedet
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  3. Elizabeth Buss Lunardelli
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  4. Henrique Delziovo
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  6. Francieli Vuolo
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  7. Cristiane Damiani Tomasi
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  8. Roger Walz
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  9. Cristiane Ritter
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  10. Felipe Dal-Pizzol
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Contributions

MM and SRB were involved in the conception and design, data acquisition, analysis and interpretation of the data, and drafting the manuscript. EBL, HD, RLD, and FV were involved in the conception and design and data acquisition. CDT, CR, and FD-P were involved in the conception and design, analysis and interpretation of the data, and drafting the manuscript.

Corresponding author

Correspondence to Felipe Dal-Pizzol.

Ethics declarations

The institutional review board at Hospital São José (number 61541616.7.0000.5364) approved the study, and a written informed consent was obtained from all participants or their proxies.

Conflict of Interest

The authors declare that they have no competing interests.

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Maciel, M., Benedet, S.R., Lunardelli, E.B. et al. Predicting Long-term Cognitive Dysfunction in Survivors of Critical Illness with Plasma Inflammatory Markers: a Retrospective Cohort Study. Mol Neurobiol 56, 763–767 (2019). https://doi.org/10.1007/s12035-018-1166-x

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  • DOI: https://doi.org/10.1007/s12035-018-1166-x

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