Abstract
Objective: The aims of this study were to investigate the changes in serum cholesterol levels at the onset of bloodstream infection (BSI) and to determine whether serum cholesterol levels were associated with patients’ clinical backgrounds and the prognosis of BSI; Methods: A retrospective chart review was done to collect demographic information and the subjects’ medical history, invasive procedures, and medications; Patients and Methods: From April 2003 to March 2006, all patients aged ≥20 years with positive blood cultures in the University of Tokyo Hospital (a tertiary teaching hospital with 1200 beds) were enrolled; Results: Average cholesterol levels before the onset of BSI were 166.5 ± 46.5 mg/dL, and, at the onset of BSI, they decreased to 134.4 ± 45.0 mg/dL (p < 0.001). Thirty-day survivors had higher cholesterol levels both before and at the onset of BSI than non-survivors. Cholesterol levels at the onset of BSI were associated with the organisms of BSI. Patients with lower cholesterol levels tended to have higher 30-day mortality rates and longer medical treatment than patients with higher cholesterol levels (13% vs 3%, p = 0.12; 24.3 days vs 18.4 days, p = 0.15); Conclusion: Cholesterol levels at the onset of BSI could be used as a prognostic marker in patients with BSI.
Highlights
Infection and inflammation induce the acute phase response, which leads to multiple changes in lipid metabolism
No previous studies have determined whether serum cholesterol levels and their changes at the onset of bloodstream infection (BSI) are associated with the causative organisms of BSI and the prognosis of BSI
We investigated whether serum cholesterol levels changed at the onset of BSI, and whether serum cholesterol levels were associated with the pathogens and the clinical outcome of BSI
Summary
Infection and inflammation induce the acute phase response, which leads to multiple changes in lipid metabolism. It was previously reported that, over the clinical course of severe sepsis, plasma cholesterol levels rapidly decreased and increased slowly [2]. The cholesterol levels prior to the onset of sepsis were not reported. To the best of our knowledge, there have been no reports dealing with the changes in serum cholesterol levels from the pre-clinical stage of bloodstream infection (BSI) to the onset of BSI. A previous study reported that lower plasma cholesterol levels were observed in patients with sepsis caused by gram-positive cocci or gram-negative rods [2]. No previous studies have determined whether serum cholesterol levels and their changes at the onset of BSI are associated with the causative organisms of BSI and the prognosis of BSI. We investigated whether serum cholesterol levels changed at the onset of BSI, and whether serum cholesterol levels were associated with the pathogens and the clinical outcome of BSI
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