Abstract
Objective:Hypocholesterolemia is a critical observation following trauma and probably contributes to inflammation during critical illness. This study has been conducted to document the cholesterol level at different time intervals in patients with sepsis and to correlate its trend with survival.Methods: Fifty-five patients from ICU meeting the criteria of sepsis were included in the study. Total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides were measured at the onset of sepsis (0 hour), at 24 hour and at 72 hour. The hypocholesterolemia cut off level (total cholesterol <130 mg/dL) was further correlated with survival and non survival for a period of 28 days. Results: The mean total cholesterol, HDL-C and LDL-C levels in the non surviving group were significantly less than the surviving group (p=0.000, p=0.008, p=0.04). The difference in the triglyceride level was not significant. On further analysis it was observed that the cholesterol level at the onset of sepsis (0 hour) could be used as an indicator of survival. Conclusion: The cholesterol level is altered and although the reason is not understood, it is for certain that there is a positive relationship between low serum cholesterol levels, and increased mortality. Since no data on cholesterol and lipoprotein concentrations before the septic episode are available, it was not possible to be sure whether concentrations are low because of the inflammatory response or whether the patients are susceptible to infection as a result of low lipoprotein concentrations. However, from the observations we would like to suggest that, low serum cholesterol concentrations represent a potential therapeutic target for better management of sepsis.