DETECTABLE SERUM LEVELS OF TUMOR-NECROSIS-FACTOR-ALPHA MAY PREDICT EARLY MORTALITY IN ELDERLY INSTITUTIONALIZED PATIENTS

Objective: To determine if detectable serum tumor necrosis factor alpha (TNF) levels are associated with higher mortality in nursing home residents. Subjects and methods: The basal serum concentrations of TNF and interleukin-1 alpha (IL-1) were measured in 129 elderly nursing home patients (mean age of 89 years), and survival in the cohort was monitored over a 13-month period. Results: At 4 months follow-up, seven out of 33 patients with detectable serum TNF levels had died (21.2%), and only three out of 96 patients with undetectable serum TNF levels had died (3.1%) (P < 0.001). The difference in mortality remained significant up to 13 months of follow-up (P < 0.05). Those with detectable serum TNF levels and those with undetectable levels were comparable in age, body mass index, hematocrit, lymphocyte counts, and serum level of albumin, prealbumin, and retinol-binding protein. When patients with detectable serum IL-1 levels were compared to those with undetectable levels, there were no significant differences in mortality over a 13-month period. Conclusion: Detectable serum TNF levels in elderly nursing home patients may be a predictor of early mortality.