1. Impact of the pre-illness lipid profile on sepsis mortality
- Author
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Michael D. Maile, Matthew J. G. Sigakis, Milo Engoren, Elizabeth S. Jewell, and Kathleen A. Stringer
- Subjects
Adult ,Male ,medicine.medical_specialty ,Organ Dysfunction Scores ,Critical Care and Intensive Care Medicine ,Article ,Sepsis ,Tertiary Care Centers ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Severity of illness ,medicine ,Humans ,Hospital Mortality ,Triglycerides ,Retrospective Studies ,Inflammation ,medicine.diagnostic_test ,Cholesterol ,business.industry ,030208 emergency & critical care medicine ,Odds ratio ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Confidence interval ,Systemic Inflammatory Response Syndrome ,Systemic inflammatory response syndrome ,Hospitalization ,Intensive Care Units ,030228 respiratory system ,chemistry ,Multivariate Analysis ,SOFA score ,Female ,Lipid profile ,business - Abstract
Purpose To determine if baseline lipid levels contribute to the relationship between lipid levels during sepsis and outcomes. Materials and methods We conducted a retrospective cohort study at a tertiary-care academic medical center. Multivariable logistic regression models were used to adjust for confounders. Both Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) score-based definitions of sepsis were analyzed. Measurements and main results After adjusting for patient characteristics and severity of illness, baseline values for both low density lipoprotein (LDL) cholesterol and triglycerides were associated with mortality (LDL cholesterol odds ratio [OR] 0.44, 95% confidence interval [CI] 0.23–0.84, p = .013; triglyceride OR 0.54, 95% CI 0.37–0.78, p = .001) using a SIRS based definition of sepsis. An interaction existed between these two variables, which resulted in increased mortality with higher baseline low density lipoprotein (LDL) cholesterol values for individuals with triglycerides below 208 mg/dL and the opposite direction of association above this level (interaction OR 1.48, 95% CI 1.02–2.16, p = .039). When using a SOFA score-based definition, only triglycerides remained associated with the mortality (OR 0.55, 95% CI 0.35–0.86, p = .008). Conclusions Baseline lipid values, particularly triglyceride concentrations, are associated with hospital mortality in septic patients.
- Published
- 2019