Evidence map›Paper›PMID 25124807›Full record

ArticleJournal of psychosomatic research2014

Cerebrospinal fluid markers of neuroinflammation in delirium: a role for interleukin-1β in delirium after hip fracture.

Eleanor Cape, Roanna J Hall, Barbara C van Munster, Annick de Vries, Sarah E M Howie, Andrew Pearson, Scott D Middleton, Fiona Gillies, Ian R Armstrong, Tim O White and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of psychosomatic research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 5 pooled it
5.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 5 syntheses or guidelines pooled it, 136 citations in OpenAlex.

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  14. Molecular and Clinical Considerations for Anesthesia in the Aging Brain.International journal of molecular sciences · 2025
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  16. Nicotinamide Prevents the Plasticity Impairments and the Cognitive Dysfunction Caused by Bone Fracture in Older Mice.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025
    Article
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  18. Article
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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 9 institutions in 4 countries.

Eleanor CapeEdinburgh Delirium Research Group, University of Edinburgh, Edinburgh, Scotland, UK.
Roanna J HallEdinburgh Delirium Research Group, University of Edinburgh, Edinburgh, Scotland, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, UK; Department of Geriatrics, Western General Hospital, Edinburgh, Scotland, UK. Electronic address: roanna.hall@nhslothian.scot.nhs.uk.
Barbara C van MunsterDepartment of Medicine, Amsterdam Delirium Study Group, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Geriatrics, Gelre Hospitals, Apeldoorn, The Netherlands.
Annick de VriesUniversity of Leuven, Leuven, Belgium.
Sarah E M HowieCentre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland, UK.
Andrew PearsonEdinburgh Delirium Research Group, University of Edinburgh, Edinburgh, Scotland, UK.
Scott D MiddletonDepartment of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
Fiona GilliesEdinburgh Delirium Research Group, University of Edinburgh, Edinburgh, Scotland, UK.
Ian R ArmstrongDepartment of Anaesthetics, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
Tim O WhiteDepartment of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
Colm CunninghamSchool of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland.
Sophia E de RooijDepartment of Medicine, Amsterdam Delirium Study Group, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Alasdair M J MacLullichEdinburgh Delirium Research Group, University of Edinburgh, Edinburgh, Scotland, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, UK.
Edinburgh Royal Infirmary · GBUniversity of Edinburgh · GBAlzheimer Scotland · GBCentre for Inflammation Research · GBGelre Hospitals · NLKU Leuven · BENHS Education for Scotland · GBTrinity College Dublin · IEUniversity of Amsterdam · NL

Funding

Biotechnology and Biological Sciences Research CouncilMedical Research Council G0901697Medical Research Council G108/646Medical Research Council MR/K026992/1Wellcome Trust 090907Wellcome Trust SRF 090907
6 · The paper itself

Abstract

objectiveExaggerated central nervous system (CNS) inflammatory responses to peripheral stressors may be implicated in delirium. This study hypothesised that the IL-1β family is involved in delirium, predicting increased levels of interleukin-1β (IL-1β) and decreased IL-1 receptor antagonist (IL-1ra) in the cerebrospinal fluid (CSF) of elderly patients with acute hip fracture. We also hypothesised that Glial Fibrillary Acidic Protein (GFAP) and interferon-γ (IFN-γ) would be increased, and insulin-like growth factor 1 (IGF-1) would be decreased.

methodsParticipants with acute hip fracture aged >60 (N=43) were assessed for delirium before and 3-4 days after surgery. CSF samples were taken at induction of spinal anaesthesia. Enzyme-linked immunosorbent assays (ELISA) were used for protein concentrations.

resultsPrevalent delirium was diagnosed in eight patients and incident delirium in 17 patients. CSF IL-1β was higher in patients with incident delirium compared to never delirium (incident delirium 1.74 pg/ml (1.02-1.74) vs. prevalent 0.84 pg/ml (0.49-1.57) vs. never 0.66 pg/ml (0-1.02), Kruskal-Wallis p=0.03). CSF:serum IL-1β ratios were higher in delirious than non-delirious patients. CSF IL-1ra was higher in prevalent delirium compared to incident delirium (prevalent delirium 70.75 pg/ml (65.63-73.01) vs. incident 31.06 pg/ml (28.12-35.15) vs. never 33.98 pg/ml (28.71-43.28), Kruskal-Wallis p=0.04). GFAP was not increased in delirium. IFN-γ and IGF-1 were below the detection limit in CSF.

conclusionThis study provides novel evidence of CNS inflammation involving the IL-1β family in delirium and suggests a rise in CSF IL-1β early in delirium pathogenesis. Future larger CSF studies should examine the role of CNS inflammation in delirium and its sequelae.

Indexed as

AgedAged, 80 and overBiomarkersDeliriumFemaleGlial Fibrillary Acidic ProteinHip FracturesHumansInflammationInsulin-Like Growth Factor IInterferon-gammaInterleukin-1betaMaleMiddle AgedBiomarkersGlial Fibrillary Acidic ProteinInsulin-Like Growth Factor IInterferon-gammaInterleukin-1betaCerebrospinal fluidDeliriumInflammationInterleukin-1 receptor antagonistInterleukin-1β

Identifiers

PMID25124807
PMCPMC4274366
OpenAlexW2119251258

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.