Leardi S, Altilia F, Delmonaco S, Cianca G, Pietroletti R, Simi M
Università di L'Aquila, Dipartimento Discipline Chirurgiche.
Ann Ital Chir. 2000 Mar-Apr;71(2):233-7.
Hypocholesterolemia seems to represent a significant predictive factor of morbidity and mortality in critically ill patients. The authors, on the basis of recent literature data, aim to clarify the possible correlation between preoperative hypocholesterolemia and the risk of septic postoperative complications .205 patients undergoing to surgery for gastrointestinal diseases were the object of the study. Patients undergoing "minor" abdominal surgery or video-laparoscopic surgery and classified ASA III-IV were excluded. In all the patients, we considered retrospectively risk factors for postoperative septic complications as follows: preoperative blood concentration of cholesterol, malnutrition, obesity, diabetes, neoplasm, preoperative sepsis, type and duration of operations, antibiotics and regimen of use. Type and incidence of postoperative local or systemic septic complications were recorded. The patients have been stratified according to blood concentration of cholesterol and to the presence or absence of other risk factors. The incidence of postoperative sepsis was 35.1%. The highest incidence of postoperative septic complications (72.7%) was encountered, significantly (X2 = 7.6, p < 0.001), in the patients (11 cases, 5.9%) with cholesterol levels below 105 mg/dl). The results of this study seems to indicate a significant relationship between preoperative hypocholesterolemia and the incidence of septic complications after surgery. Moreover, evaluation of blood cholesterol levels before major surgery might represent a predictive factor of septic risk in the postoperative period.
低胆固醇血症似乎是危重症患者发病和死亡的一个重要预测因素。作者基于近期文献数据,旨在阐明术前低胆固醇血症与术后感染性并发症风险之间的可能关联。205例接受胃肠道疾病手术的患者为研究对象。接受“小型”腹部手术或电视腹腔镜手术且ASA分级为III - IV级的患者被排除。在所有患者中,我们回顾性地考虑了以下术后感染性并发症的危险因素:术前胆固醇血浓度、营养不良、肥胖、糖尿病、肿瘤、术前脓毒症、手术类型和持续时间、抗生素及使用方案。记录术后局部或全身感染性并发症的类型和发生率。患者已根据胆固醇血浓度以及其他危险因素的有无进行分层。术后脓毒症的发生率为35.1%。胆固醇水平低于105mg/dl的患者(11例,5.9%)术后感染性并发症的发生率最高(72.7%),差异有统计学意义(X2 = 7.6,p < 0.001)。本研究结果似乎表明术前低胆固醇血症与术后感染性并发症的发生率之间存在显著关联。此外,大手术前评估血胆固醇水平可能是术后感染风险的一个预测因素。