Does Age Have an Effect on Systemic Inflammatory Response?

To the Editor:

We congratulate Ohira et al on their interesting study.¹ Contrary to popular belief, there are many studies reporting that age doesn’t have that much effect on coronary bypass grafting surgery results.^2,3 However, the important point for us is what causes that result. In open heart surgery, especially in coronary bypass grafting with cardiopulmonary bypass, systemic inflammatory response syndrome (SIRS) affects operative results.^4–6 SIRS can be detected by the help of inflammation markers such as interferon and tumor necrosis factor. In the postoperative period, the existence of 2 of the parameters – hypo/hyperthermia, tachy/bradycardia and leukocytosis/leukopenia – is accepted as enough for diagnosis.⁷ Can we claim that SIRS frequency changes according to age as the immune system gets older where patients who underwent coronary bypass grafting surgery are considered? On this point, it becomes very important whether or not any significant differences exist among groups for these findings in the study of Ohira et al. We think the ideas of the authors on this point add value to their study.

• Orhan Gokalp, MD
• Ali Gurbuz, MD
• Department of Cardiovascular Surgery, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
• Nihan Karakas Yesilkaya, MD
• Yuksel Besir, MD
• Department of Cardiovascular Surgery, Ataturk Education and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
• Gamze Gokalp, MD
• Department of Pediatric Emergency, Tepercik Education and Research Hospital, Izmir, Turkey

(Released online November 24, 2015)

References

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• 2.    Rosato  S,  Biancari  F,  D’Errigo  P,  Fusco  D,  Seccareccia  F. Midterm outcome of coronary artery bypass grafting in young patients: A multicenter Italian study. Ann Thorac Surg 2015; 100: 1689–1696.
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• 4.    Raja  SG,  Berg  GA. Impact of off-pump coronary artery bypass surgery on systemic inflammation: Current best available evidence. J Card Surg 2007; 22: 445–455.
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• 6.    Wehlin  L,  Vedin  J,  Vaage  J,  Lundahl  J. Activation of complement and leukocyte receptors during on- and off-pump coronary artery bypass surgery. Eur J Cardiothorac Surg 2004; 25: 35–42.
• 7.    Dellinger  RP,  Levy  MM,  Carlet  JM,  Bion  J,  Parker  MM,  Jaeschke  R, et al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock Crit Care Med 2008; 36: 296–327.