Analysis of Prognostic Significance of Serum HDL Level in Patients of Sepsis Admitted to a Tertiary Care Hospital of Southern Odisha

Abstract

BACKGROUND Sepsis is the body’s overwhelming and life-threatening response to infection that may cause tissue damage, organ failure and death. High density lipoproteins (HDL) are relevant players in both innate and adaptive immunity involved in response to infection. So, with this reference and limited number of studies showing association of prognosis with high-density lipoprotein level in sepsis patients, this study was done to find out the changes in HDL level of sepsis patients and its association with prognosis. METHODS This is a prospective hospital-based study done on 210 patients with sepsis admitted in medicine ward and intensive care unit (ICU) of M.K.C.G Medical College, Odisha from November 2017 to November 2019. Patient’s included in study are based on initial assessment by quick SOFA (Qsofa) scoring system. At the time of admission, patient’s clinical history, relevant biochemical parameters were noted and detail clinical examination was done. All the patients were followed prospectively during their entire course of stay. Serum HDL was done on the day of admission and was repeated on day 4 and on day of discharge. Outcome was measured in terms of survival and duration of hospital stay. RESULTS Out of 210 patients, 168 (80 %) survived and 42 (20 %) cases died. Survival rate was significantly higher in patients admitted to ward than those in ICU. HDL level on day 1 showed significant inverse correlation with SOFA score. Inverse correlation was also observed between the duration of stay in hospital and HDL on day 1. Significantly higher level of HDL was observed in patients who survived than non-survivors. In cases which survived, a statistically significant increase was observed in HDL level from day 1 to day of discharge. CONCLUSIONS HDL cholesterol on day of admission can be viewed as a significant predictor of mortality in patients of sepsis. KEYWORDS HDL, sepsis, prognosis, qSOFA, SOFA