Document Detail


Hypocholesterolemia and risk of death in the critically ill surgical patient.
MedLine Citation:
PMID:  8880248     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the additional information provided by the determination of cholesterolemia to the Acute Physiology and Chronic Health Evaluation (APACHE) II score. DESIGN: Retrospective evaluation of patients admitted to the intensive care unit (ICU). SETTING: ICUs in a university hospital. PATIENTS: 638 consecutive critically ill surgical patients. INTERVENTIONS: Surgical and medical therapy according to clinical status. MEASUREMENTS AND MAIN RESULTS: Two indices were devised: DELCUPOS and DELCUNEG (cubed absolute value of the difference between measure cholesterol and the value of 190 mg/dl when cholesterolemia was, respectively, over and under 190 mg). The first estimation of cholesterolemia was taken upon admission to the ICU. The APACHE II score was computed from teh worst values obtained during the first 24h of the ICU stay, including the pre-operative period for patients transferred from the operating theatre. Mortality (24.4%) over the whole time of hospitalization has been considered. A stepwise linear logistic regression on APACHE II, DELCUPOS, DELCUNEG, and on interactions among these three factors has been carried out. A U-shaped relationship between cholesterolemia and morality was demonstrated. The significance of DELCUPOS (p = 0.0021) and DELCUNEG (p = 0.0002), considered together with the APACHE II score, has demonstrated an additive information content with respect to the APACHE score for the prediction of mortality. CONCLUSION: Both hyper- and hypocholesterolemia have a highly significant relationship to mortality. Cholesterolemia improves the prognostic power of the APACHE II score. This result could be used to create a more powerful prognostic index.
Authors:
D Gui; P L Spada; A De Gaetano; F Pacelli
Related Documents :
17117128 - A modified goal-directed protocol improves clinical outcomes in intensive care unit pat...
23656848 - Bupropion for overweight women with binge-eating disorder: a randomized, double-blind, ...
12590238 - Balthazar computed tomography severity index is superior to ranson criteria and apache ...
8386998 - Longitudinal analysis of neutrophil superoxide anion generation in patients with septic...
16610738 - Community-based trial of a triple-combination agent for the treatment of facial melasma.
352788 - Corticosteroid therapy of alcoholic hepatitis.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  22     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1997-03-06     Completed Date:  1997-03-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  790-4     Citation Subset:  IM    
Affiliation:
CNR Centro Studio Fisiopatologia dello Shock, Istituto Clinica Chirurgica, Università Cattolica S. Cuore, Rome, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
APACHE
Cholesterol / blood
Critical Illness / classification,  mortality*
Female
Hospital Mortality
Humans
Hypercholesterolemia / blood,  complications*
Intensive Care Units
Logistic Models
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Chemical
Reg. No./Substance:
57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Analysis of P50 and oxygen transport in patients after cardiac surgery.
Next Document:  Different effects of early endotoxaemia on hepatic and small intestinal oxygenation in pigs.