Abdul Malick Afrah, Manavalan Jeyakumar, Murugiah Viveka, Bose Manikandan, Alexander Hariharan, Kanakasekaran Suganthy
Velammal Medical College Hospitals and Research Institute, Madurai, Tamil Nadu, India.
Sri Manakula Vinayagar medical college and Hospital, Puducherry, India.
J Crit Care Med (Targu Mures). 2024 Apr 30;10(2):139-146. doi: 10.2478/jccm-2024-0015. eCollection 2024 Apr.
Sepsis is the major cause of morbidity and mortality for patients admitted to an intensive care unit worldwide. Currently, procalcitonin (PCT) is a widely used prognostic marker for sepsis. The high cost of estimating Procalcitonin limits its utility in all health facilities. Lipid profile, being a frequently done routine investigation, is studied in sepsis patients to predict the prognosis of sepsis. This study was aimed to assess the association between lipid profile parameters, procalcitonin and clinical outcomes in patients with sepsis.
It is a prospective observational study conducted in a tertiary care hospital in the Department of Biochemistry in collaboration with the Intensive Care Unit (ICU). We included 80 sepsis patients from medical and surgical ICUs. Among them, 59 (74%) survived and 21 (26%) expired. Serum lipid profile, procalcitonin and variables required for APACHE II score are measured at two intervals, one during admission and on day 5. All the parameters were compared between the survivors and the non-survivors.
Serum PCT levels were reduced on day 5 [3.32 (1.27-11.86)] compared to day 0 [13.42 (5.77-33.18)] in survivors. In survivors, Total Cholesterol, LDL-C and Non-HDL-C were significantly elevated on day 5 compared to day 0. In non-survivors, HDL-C significantly decreased on day 5. Between survivors and non-survivors, HDL-C significantly decreased on day 5 (23.88 ± 10.19 vs 16.67 ± 8.27 mg/dl). A Negative correlation was observed between HDL-C & PCT.
Serum Lipid profile levels, namely Total cholesterol, HDL-C and LDL-C, have possible associations with the severity of sepsis. HDL-C have a negative association with the clinical scoring system in sepsis patients. Overall, the findings from our study suggest that lipid profile parameters have possible implications in predicting the outcome of patients with sepsis.
脓毒症是全球重症监护病房患者发病和死亡的主要原因。目前，降钙素原（PCT）是脓毒症广泛应用的预后标志物。降钙素原检测成本高昂，限制了其在所有医疗机构的应用。血脂谱作为一项经常进行的常规检查，在脓毒症患者中进行研究以预测脓毒症的预后。本研究旨在评估脓毒症患者血脂谱参数、降钙素原与临床结局之间的关联。
这是一项在一家三级护理医院的生物化学科与重症监护病房（ICU）合作开展的前瞻性观察性研究。我们纳入了来自内科和外科ICU的80例脓毒症患者。其中，59例（74%）存活，21例（26%）死亡。在两个时间点测量血清血脂谱、降钙素原和急性生理与慢性健康状况评分系统（APACHE II）评分所需的变量，一个是入院时，另一个是第5天。对幸存者和非幸存者的所有参数进行比较。
幸存者第5天的血清PCT水平[3.32（1.27 - 11.86）]低于第0天[13.42（5.77 - 33.18）]。在幸存者中，第5天的总胆固醇、低密度脂蛋白胆固醇（LDL-C）和非高密度脂蛋白胆固醇（Non-HDL-C）较第0天显著升高。在非幸存者中，第5天高密度脂蛋白胆固醇（HDL-C）显著降低。在幸存者和非幸存者之间，第5天HDL-C显著降低（23.88±10.19 vs 16.67±8.27mg/dl）。观察到HDL-C与PCT之间呈负相关。
血清血脂谱水平，即总胆固醇、HDL-C和LDL-C，可能与脓毒症的严重程度有关。HDL-C与脓毒症患者的临床评分系统呈负相关。总体而言，我们研究的结果表明血脂谱参数在预测脓毒症患者的结局方面可能具有重要意义。
