Serum cholesterol as a predictor of mortality among the elderly patients with pneumonia in the emergency department

Ko, Seok Hoon; Lee, Jong Seok; Kim, Sung Kyoo; Jeong, Ki Young

doi:10.1016/j.ajem.2020.09.012

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…In agreement with our study, Ko et al found that a low level of total serum cholesterol at admission in the pneumonia group with a statically significant difference. In disagreement with our study, Chien et al found that serum HDL, cholesterol, and LDL on admission had no significant difference between the two studied groups [19,20].…”

Section: Discussioncontrasting

confidence: 99%

Role of cholesterol, lipoproteins, and neutrophilic-lymphocytic ratio in patients with pneumonia

El-Aaty

Elmahallawy

Elmaksoud³

et al. 2022

Egypt J Bronchol

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Background Lipids play numerous functions in lung biology and pathophysiology of infection, in addition to their role in lipid transport, lipoproteins share in innate immunity that is the most important way for the host to defend against microbes. The NLR (neutrophil-lymphocytic ratio) is a good indicator of systemic inflammation and infection. Objective To evaluate the role of cholesterol, lipoproteins, and neutrophilic-lymphocytic ratio in the assessment of patients with pneumonia. Patients and methods This prospective case–control study included 52 subjects; they were categorized into 2 groups. Group A included 42 patients with pneumonia admitted to the Chest Department,Menoufia University, and group B included 10 healthy people during the period from May 2019 to December 2019. History taking, clinical examination, laboratory investigation in the form of CBC and lipid profile, and radiological investigation in the form of CXR and CT chest if needed were done to all subjects of the study. Results The mean cholesterol level in group A was 149.76 ± 42.79 which was statistically significantly lower as compared with group B (165.90 ± 45.50) (p = 0.039). The mean HDL level in group A was 43.16 ± 6.32 which was statistically significantly lower as compared with group B (50.51 ± 9.60) (p = 0.026). No statistically significant difference was found in the triglyceride level, LDL level and VLDL between the subjects in the two studied groups (p = 0.479, 0.792, and 0.606), respectively, but all levels were still within normal levels. Mean NLR in group A was 7.04 ± 7.98 which was statistically significantly higher as compared with group B (3.04 ± 1.6) (p = 0.004). Roc curve of neutrophil–lymphocyte ratio shows that the cutoff point is 1.94 and the N/L ratio had area under curve of 78% with 79.6% sensitivity and 67.8% specificity. Conclusion Serum cholesterol and high-density lipoprotein levels significantly decreased in patients with pneumonia when compared to the control group but were still within normal range. Lipid profile is affected by different variables like smoking index, body mass index, and sex. The neutrophil–lymphocyte at cutoff point is 1.94, and N/L ratio had area under curve of 78% with 79.6% sensitivity and 67.8% specificity. Trial registration TCTR, TCTR20220524001. Registered on 24 May 2022, retrospectively registered.

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Section: Discussioncontrasting

confidence: 99%

Role of cholesterol, lipoproteins, and neutrophilic-lymphocytic ratio in patients with pneumonia

El-Aaty

Elmahallawy

Elmaksoud³

et al. 2022

Egypt J Bronchol

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“…25-hydroxycholesterol (25HC) is one of the metabolites of cholesterol, and 25HC inhibits coronavirus infection by blocking membrane fusion ( 50 ), so lower total cholesterol levels may lead to lower 25HC levels, increasing the chance of coronavirus infection in SCZ patients and potentially explaining the correlation between viral infection and lower cholesterol levels ( 51 , 52 ). Lower total cholesterol may also be a factor of increased short-term mortality in elderly patients with community-acquired pneumonia (CAP) ( 53 ). In addition, men may be more sensitive to low levels of cholesterol ( 54 ), which accounts for the fact that men with low total cholesterol levels were more likely to develop HAP in our study, whereas women showed no statistical difference in HAP based on the level of total cholesterol.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in factors influencing hospital-acquired pneumonia in schizophrenia patients receiving modified electroconvulsive therapy

Yang

Yang²,

Liu³

et al. 2023

Front. Psychiatry

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BackgroundSex differences may be presented in the clinical features or symptoms of schizophrenia patients but also affect the occurrence of hospital-acquired pneumonia (HAP). Modified electroconvulsive therapy (mECT) is a common treatment method for schizophrenia, used in combination with antipsychotics. This retrospective research explores the sex difference in HAP affecting patients with schizophrenia who have received mECT treatment during hospitalization.MethodsWe included schizophrenia inpatients treated with mECT and antipsychotics between January 2015 and April 2022. Blood-related and demographic data collected on admission were analyzed. Influencing factors of HAP in male and female groups were assessed separately.ResultsA total of 951 schizophrenia patients treated with mECT were enrolled in the study, including 375 males and 576 females, of which 62 patients experienced HAP during hospitalization. The risk period of HAP in these patients was found to be the first day after each mECT treatment and the first three sessions of mECT treatment. Statistically significant differences in the incidence of HAP were identified in male vs. female groups, with an incidence in men about 2.3 times higher than that in women (P < 0.001). Lower total cholesterol (Z = −2.147, P = 0.032) and the use of anti-parkinsonian drugs (χ2 = 17.973, P < 0.001) were found to be independent risk factors of HAP in male patients, while lower lymphocyte count (Z = −2.408, P = 0.016), hypertension (χ2 = 9.096, P = 0.003), and use of sedative-hypnotic drugs (χ2 = 13.636, P < 0.001) were identified in female patients.ConclusionInfluencing factors of HAP in schizophrenia patients treated with mECT have gender differences. The first day after each mECT treatment and the first three sessions of mECT treatment were identified to have the greatest risk for HAP development. Therefore, it would be imperative to monitor clinical management and medications during this period according to these gender differences.

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“…Epidemiological investigation shows the incidence of SCAP tends to increase markedly with age (persons aged 65 years or older) [ 1 , 5 ]. Especially in developed countries, it has been reported that almost half of the hospitalizations for pneumonia occurs in patients over 65 years [ 15 ]. In our study population, SCAP patients older than 65 years accounted for about 43%.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile analysis and nomogram for predicting in-hospital mortality among elderly severe community-acquired pneumonia patients with comorbid cardiovascular disease: a retrospective cohort study

Gong

Huang

et al. 2022

BMC Pulm Med

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Background Researchers have linked cardiovascular disease (CVD) with advancing age; however, how it drives disease progression in elderly severe community acquired pneumonia (SCAP) patients is still unclear. This study aims to identify leading risk predictors of in-hospital mortality in elderly SCAP patients with CVD, and construct a comprehensive nomogram for providing personalized prediction. Patients and methods The study retrospectively enrolled 2365 elderly patients identified SCAP. Among them, 413 patients were found to have CVD. The LASSO regression and multivariate logistic regression analysis were utilized to select potential predictors of in-hospital mortality in elderly SCAP patients with CVD. By incorporating these features, a nomogram was then developed and subjected to internal validations. Discrimination, calibration, and clinical use of the nomogram were assessed via C-index, calibration curve analysis, and decision plot. Results Compared with patients without CVD, elderly SCAP patients with CVD had a significant poor outcome. Further analysis of the CVD population identified 7 independent risk factors for in-hospital mortality in elderly SCAP patients, including age, the use of vasopressor, numbers of primary symptoms, body temperature, monocyte, CRP and NLR. The nomogram model incorporated these 7 predictors showed sufficient predictive accuracy, with the C-index of 0.800 (95% CI 0.758–0.842). High C-index value of 0.781 was obtained in the internal validation via bootstrapping validation. Moreover, the calibration curve indicative a good consistency of risk prediction, and the decision curve manifested that the nomogram had good overall net benefits. Conclusion An integrated nomogram was developed to facilitate the personalized prediction of in-hospital mortality in elderly SCAP patients with CVD.

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Serum cholesterol as a predictor of mortality among the elderly patients with pneumonia in the emergency department

Cited by 5 publications

References 24 publications

Role of cholesterol, lipoproteins, and neutrophilic-lymphocytic ratio in patients with pneumonia

Role of cholesterol, lipoproteins, and neutrophilic-lymphocytic ratio in patients with pneumonia

Sex differences in factors influencing hospital-acquired pneumonia in schizophrenia patients receiving modified electroconvulsive therapy

Clinical profile analysis and nomogram for predicting in-hospital mortality among elderly severe community-acquired pneumonia patients with comorbid cardiovascular disease: a retrospective cohort study

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