TNF and systemic inflammatory response syndrome: Some studies found no association between age and systemic inflammatory mediators,21,22 whereas others reported a marked increase in inflammatory cytokines; in particular, interleukin-1 (IL1), IL6 and tumour necrosis factoralpha (TNF-α) levels were higher in older than in younger patients.23,24 We used clinical parameters but not markers of inflammation to evaluate the effects of age on SIRS.