Changes in plasma lipid and in-hospital deaths in patients with sepsis

Background: Lipid profiles are infrequently measured in clinical management of sepsis patients. Sepsis leads to significant alterations in the metabolism of lipids. The aim of the present study was to determine whether changes in plasma lipid concentrations during sepsis treatment were associated with clinical outcome. Methods: In this study, 74 adult septic patients were included in this prospective observational study from January to December 2017. Patients taking lipid lowering agents were excluded. A detailed medical history was obtained and clinical examination was performed. Serum total cholesterol (STC) and its fractions [low-and high-density lipoprotein] and triglyceride levels were measured in the morning of the first day after admission and then once weekly. The primary outcomes of the study were in-hospital mortality, and hospital stay and hypocholesterolemia were defined as STC levels < 50 mg/dL. Manne-Whitney U and chi-squared tests were used for data analysis, and significance level was set at p<0.05. Results: In this study, 78.4% (CI 95%: 67.3-87.1) of patients had hypocholesterolemia. During the study period, 21.6% (CI 95%: 12.9- 32.7) of patients died. All lipid (except TG) concentrations continuously decreased in deceased sepsis patients but increased in recovering patient (p value for STC (p=0.004), LDL (p=0.006), HDL (p=0.010), and TG (p=0.052)). The serum lipids concentration was not associated with length of hospital stay (p value for STC (p=0.524), LDL (p=0.813), HDL (p=0.799) and TG (p=0.581)). Conclusion: In this study it was found that the additional decline of lipid profile was significantly associated with increased mortality rate of sepsis patients. Thus, the clinically termed 'the lipaemia of sepsis' is not true in all situations.