Decreased serum level of lipoprotein cholesterol is a poor prognostic factor for patients with severe community-acquired pneumonia that required intensive care unit admission

J Crit Care. 2015 Jun;30(3):506-10. doi: 10.1016/j.jcrc.2015.01.001. Epub 2015 Jan 8.

Abstract

Purpose: The purpose of this study is to investigate the prognostic values of the serum levels of lipids in patients with severe community-acquired pneumonia (CAP) that required intensive care unit (ICU) admission.

Materials and methods: Patients who had severe CAP that required ICU admission were included. Serum lipid level was collected on the days 1 and 7 of ICU stay. Clinical outcome, including length of ICU stay, hospital stay, and death, were monitored prospectively.

Results: A total of 40 patients were enrolled in this study. Lower high-density lipoprotein (HDL) and low-density lipoprotein (LDL) were found in nonsurvival group on ICU admission day 7 (survivors vs nonsurvivors; mean HDL, 41.8 vs 13.0 mg/dL, P = .002; LDL, 62.3 vs 30.3 mg/dL, P = 0.006, respectively). High-density lipoprotein cholesterol level of less than or equal to 17 mg/dL on day 7 (odds ratio, 1.23) and LDL cholesterol level of less than or equal to 21 mg/dL on day 7 (odds ratio, 1.10) could be a predictor of hospital mortality. The mean change in levels of HDL cholesterol in nonsurvivors decreased significantly than those in survivors from days 1 to 7 (8.5 vs -17.4 mg/dL, P = .04) but not LDL cholesterol.

Conclusions: Decreased serum HDL cholesterol level from days 1 to 7 may be of prognostic value.

Keywords: Cholesterol; Critical care; Lipoprotein; Pneumonia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood*
  • Cohort Studies
  • Community-Acquired Infections / blood
  • Community-Acquired Infections / mortality
  • Disease Progression
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Pneumonia / blood*
  • Pneumonia / mortality
  • Prognosis
  • Prospective Studies

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL