IntroductionThere is evidence of positive relationships between cholesterol concentration and risk of cardiovascular diseases. However, higher mortality in patients with a low cholesterol level has been reported (the “cholesterol paradox”).Material and methodsMedical records of 34 191 inpatients between 2014 and 2016 were reviewed and the relationships between total (TC), low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C) cholesterol and triglyceride blood concentrations and all-cause in-hospital death and readmission within 14 and 30 days and 1 year were determined in univariate and multivariate analyses.ResultsPatients with TC in the lower quartile and LDL-C < 70 mg/dl had greater risk of the outcomes measured than individuals with a TC level in the remaining quartiles and LDL-C ≥ 70 mg/dl. Moreover, patients with TC in the highest quartile, OR (95% CI): 0.36 (0.13–0.99), p < 0.05, and LDL-C ≥ 115 mg/dl, OR (95% CI): 0.53 (0.37–0.77), p < 0.05, had the lowest all-cause in-hospital mortality. However, multivariate analysis using logistic regression and a Cox proportional hazard model showed no significant influence of blood lipid levels on the occurrence of the outcomes measured.ConclusionsA significant effect of a “cholesterol paradox” linking better prognosis with higher blood lipid concentration was found only in univariate analysis but, after adjustment for clinical characteristics in multivariate analysis, the plasma lipid level had a neutral influence on the occurrence of the measured outcomes. This suggests that a low cholesterol level should be interpreted as a biomarker of illness severity.
Background: It is assumed that neoplasm greater in size may affect a patients' nutritional status and prognosis stronger than smaller one. The aim of this study was to compare the nutritional status and prognosis of patients with laryngeal cancer (LC), recognized as tumour smaller in size, and patients with colorectal cancer (CRC) who were hospitalized in our hospital during the one year period. Methods: The retrospective review of medical documentation of all 1,134 patients hospitalized in a Department of Otolaryngology. Results: The laryngeal tumour was smaller than colorectal. Nutritional risk concerned 9% of patients with LC, was greater than in patients with other laryngeal disorders (1.4%), and lower than in patients with CRC (37%). A Nutritional Risk Screening (NRS) 2002 score ≥ 3 was the only significant factor influencing the risk of in-hospital all-cause mortality, 14-and 30-day readmissions in patients with LC, and the risk of 14-day rehospitalization in patients with CRC. Conclusions: Risk of malnutrition in patients with LC was lower than in counterparts with CRC, and concern 9% and 37% of patients, respectively. Nutritional risk diagnosed in patients with LC had a stronger association with the prevalence of the measured outcomes (in-hospital death, the risk of 14-day and 30-day readmission, length of hospitalization) than in individuals with CRC.
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