Cholesterol levels: the prognostic significance in ICU patients

Authors

  • Jeyasuriya A. Department of General Medicine, Velammal Medical College, Hospital and Research Institute, Madurai, Tamil Nadu, India
  • Badrinath A. K. Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
  • Saranya Nagalingam Intensive Care Unit, Velammal Medical College, Hospital and Research Institute, Madurai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20182118

Keywords:

HDL, Hypocholesterolemia, Hypercholesterolemia, ICU patients, LDL, Total cholesterol

Abstract

Background: The aims of the study were to monitor the total cholesterol levels at different time intervals in ICU patients and to analogize the values with the outcome of disease, to study the prevalence of hypocholesterolemia among ICU patients and to assess the trend of hypocholesterolemia among various diseases.

Methods: Present study populace consists of 55 patients admitted in ICU.  For these patients, lipid profile was done on the day of admission and day-3 of admission. The total cholesterol levels done on day 1 and 3 were compared with disease outcome.

Results: The mean cholesterol value among 33 survivors on day 1 was 120.76(±18.54) and day 3 was 145.30 (±55.65) with p value of 0.019, that is statistically significant. As the total cholesterol value increases during the period of ICU stay, it proves to be an  early prognostic indicator of disease outcome. The patients showing increasing trend of total cholesterol levels has increased chances of survival. Similarly, HDL value among 33 survivors on day 1 was 31.70 (±3.98) and day 3 was 36.39 (±11.98), with p value of 0.033, that is statistically significant and also, the mean LDL value among 33 survivors on day 1 was 68.25 (±17.14) and day 3 was 78.78 (±24.74), with p value of 0.009, which was also found to be statistically significant. The mean cholesterol value among 22 non-survivors on day 1 was 131.64 (±15.24) and day 3 was 122.09 (±26.23), the mean HDL among 22 non-survivors on day 1 was 33.14 (±3.79) and day 3 was 31.32 (±4.23).

Conclusions: Present study’s intend of monitoring the total cholesterol level was successfully demonstrated that it can be used as prognostic tool in ICU patients. The increasing trend in total cholesterol level indicates better prognosis of disease outcome. Similarly, the increasing trend in HDL and LDL levels also can be used as prognostic tool to determine the survival rate of patient.

References

Wilson RF, Barletta JF, Tyburski JG. Hypocholesterolemia in sepsis and critically ill or injured patients. Crit Care. 2003;7(6):413-4.

Richardson JP, Hricz L. Risk factors for the development of bacteremia in nursing home patients. Arch Fam Med. 1995;4(9):785-9.

Oster P, Muchowski H, Heuck CC, Schlierf G. The prognostic significance of hypocholesterolemia in hospitalized patients. Klin Wochenschr. 1981;59(15):857-60.

Lévesque H, Gancel A, Pertuet S, Czernichow P, Courtois H. Hypocholesterolemia: prevalence, diagnostic and prognostic value. Study in a department of internal medicine. Presse Med. 1991; 20(39):1935-8.

Ruíz-Sandoval JL, Cantú C, Barinagarrementeria F. Intracerebral hemorrhage in young people: analysis of risk factors, location, causes, and prognosis. Stroke.1999;30(3):537-41.

D'Arienzo A, Manguso F, Scaglione G, Vicinanza G, Bennato R, Mazzacca G. Prognostic value of progressive decrease in serum cholesterol in predicting survival in Child-Pugh C viralcirrhosis. Scand J Gastroenterol. 1998;33(11):1213-8.

Windler E, Ewers-Grabow U, Thiery J, Walli A, Seidel D, Greten H. The prognostic value of hypocholesterolemia in hospitalized patients. Clin Investig. 1994;72(12):939-43.

Leardi S, Altilia F, Delmonaco S, Cianca G, Pietroletti R, Simi M. Blood levels of cholesterol and postoperative septic complications. Ann Ital Chir. 2000;71(2):233-7.

Clementien VL, Marieke DB, Nimet K, et al. Serm lipids and disease severity in children with severe meningococcal sepsis. Crit Care Med. 2005;33:1610-5.

Criqui MH. Very low cholesterol and cholesterol lowering. leaflet 71-0059. American Heart Association. 1994.

Gordon BR, Parker TS, Levine DM, Saal SD, Wang JC, Sloan BJ et al. Low lipid concentrations in critical illness: implications for preventing and treating endotoxemia. Crit Care Med. 1996;24:584-9.

Gordon BR, Parker TS, Levine DM, Saal SD, Wang JC, Sloan BJ et al. Relationship of hypolipidemia to cytokine concentrations and outcomes in critically ill surgical patients. Crit Care Med. 2001;29:1563-8.

Ettinger WH, Varma VK, Sorci-Thomas M, Parks JS, Sigmon RC, Smith TK, Verdery RB. Cytokines decrease apolipoprotein accumulation in medium from Hep G2 cells. Arterioscler Thromb. 1994;14:8-13.

Fraunberger P, Schaefer S, Werdan K, Walli AK, Seidel D. Reduction of circulating cholesterol and apo lipoprotein levels during sepsis. Clin Chem Lab Med. 1999;37:357-62.

Spriggs DR, Sherman ML, Michie H, Arthur KA, Imamura K, Wilmore D et al. Recombinant human tumor necrosis factor administered as a 24-hour intravenous infusion. A phase I and pharmacologic study. J Natl Cancer Inst. 1988;80:1039-44.

Van Gameren MM, Willemse PH, Mulder NH, Limburg PC, Groen HJ, Vellenga E et al. Effects of recombinant humaninterleukin-6 in cancer patients: a phase I–II study. Blood. 1994;84:1434-41.

Windler E, Ewers-Grabow U, Thiery J, Walli A, Seidel D, Greten H. The prognostic value of hypocholesterolemia in hospitalized patients. Clin Investig. 1994 Dec;72(12):939-43.

Lévesque H, Gancel A, Pertuet S, Czernichow P, Courtois H. Hypocholesterolemia- prevalence, diagnostic and prognostic value. Presse Med. 1991 Nov;20(39):1935-8.

Das S, Bhargava S, Manocha A, Kankra M, Ray S, Srivastava LM. The prognostic value of hypocholesterolemia in sepsis. Asian J Pharm Biol Res. 2011;1(1):41-6.

Iseki K, Yamazato M, Tozawa M, Takishita S. Hypocholesterolemia is a significant predictor of death in a cohort of chronic hemodialysis patients. Kidney Int. 2002;61(5):1887-93.

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Published

2018-05-22

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Original Research Articles