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Serum total cholesterol in nosocomial infections after gastrointestinal surgery
Mitsuaki Morimoto1, Yosikazu Nakamura, Sadakane Atsuko
1Department of Surgery, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka 820-8505, Japan. mittyone2000@yahoo.co.jp
Background:
The profile of lipoprotein expression in plasma is altered by surgical stress. The role of total cholesterol in postsurgical patients with nosocomial infection remains unknown.
Methods:
We validated the data from 1,031 patients undergoing open gastrointestinal surgery between December 2006 and November 2008 using a clinical database available from Iizuka Hospital. Biochemical parameters related to plasma total cholesterol were measured. Various parameters predictive of the conditions--e.g., surgical incisional infection, organ space infection, pneumonia within 30 days after surgery--were assessed by multiple logistic regression analyses.
Results:
The most frequent infection was surgical incisional infection. Serum total cholesterol levels-(1) lowest quartile (<159 mg/dl) vs. reference (200-239 mg/dl): adjusted odds ratio (OR) 5.39, 95% confidence interval (CI) 2.28-12.76; (2) second lowest quartile (160-199 mg/dl) vs. reference: OR 2.76, 95% CI 1.01-7.53-showed a significant inverse relation with surgical incisional infection. Both lowest and highest total cholesterol levels were associated with a higher risk of surgical incisional infection and organ space infection. None of the patients with high (> or =200 mg/dl) total cholesterol levels suffered from pneumonia.
Conclusions:
Total cholesterol levels appeared to be one of the risk factors for surgical incisional infection and pneumonia. Patients with borderline blood cholesterol levels (200-239 mg/dl) seemed to be the best candidates for operation.
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