Lipid and lipoprotein predictors of functional outcomes and long-term mortality after surgical sepsis.

Autor: Guirgis FW; Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville 655 West 8th Street, Jacksonville, FL, 32209, USA. Faheem.Guirgis@jax.ufl.edu., Leeuwenburgh C; Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, FL, USA., Moldawer L; Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA., Ghita G; Department of Biostatistics, University of Florida College of Public Health and Health Professions, Gainesville, USA., Black LP; Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville 655 West 8th Street, Jacksonville, FL, 32209, USA., Henson M; Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville 655 West 8th Street, Jacksonville, FL, 32209, USA., DeVos E; Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville 655 West 8th Street, Jacksonville, FL, 32209, USA., Holden D; Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville 655 West 8th Street, Jacksonville, FL, 32209, USA., Efron P; Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA., Reddy ST; Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, 90095, USA., Moore FA; Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA.
Jazyk: angličtina
Zdroj: Annals of intensive care [Ann Intensive Care] 2021 May 20; Vol. 11 (1), pp. 82. Date of Electronic Publication: 2021 May 20.
DOI: 10.1186/s13613-021-00865-x
Abstrakt: Rationale: Sepsis is a life-threatening, dysregulated response to infection. Lipid biomarkers including cholesterol are dynamically regulated during sepsis and predict short-term outcomes. In this study, we investigated the predictive ability of lipid biomarkers for physical function and long-term mortality after sepsis.
Methods: Prospective cohort study of sepsis patients admitted to a surgical intensive-care unit (ICU) within 24 h of sepsis bundle initiation. Samples were obtained at enrollment for lipid biomarkers. Multivariate regression models determined independent risk factors predictive of poor performance status (Zubrod score of 3/4/5) or survival at 1-year follow-up.
Measurements and Main Results: The study included 104 patients with surgical sepsis. Enrollment total cholesterol and high-density lipoprotein (HDL-C) levels were lower, and myeloperoxidase (MPO) levels were higher for patients with poor performance status at 1 year. A similar trend was seen in comparisons based on 1-year mortality, with HDL-C and ApoA-I levels being lower and MPO levels being higher in non-survivors. However, multivariable logistic regression only identified baseline Zubrod and initial SOFA score as significant independent predictors of poor performance status at 1 year. Multivariable Cox regression modeling for 1-year survival identified high Charlson comorbidity score, low ApoA-I levels, and longer vasopressor duration as predictors of mortality over 1-year post-sepsis.
Conclusions: In this surgical sepsis study, lipoproteins were not found to predict poor performance status at 1 year. ApoA-I levels, Charlson comorbidity scores, and duration of vasopressor use predicted 1 year survival. These data implicate cholesterol and lipoproteins as contributors to the underlying pathobiology of sepsis.
Databáze: MEDLINE
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