title: Low cholesterol levels are associated with short-term mortality in older patients with ischemic stroke.
abstract: BACKGROUND
  The possible relationship between serum total cholesterol (TC) levels and outcome following ischemic stroke is still controversial. We evaluated the association between TC levels and 30-day mortality in a sample of older patients with acute ischemic stroke.
  
  
  METHODS
  We enrolled 490 older patients with severe ischemic stroke consecutively admitted to University Hospital's Internal Medicine or Geriatrics Department. Stroke type was classified according to the Oxfordshire Community Stroke Project. The data recorded included clinical features, medical history, electrocardiogram, and blood analyses. Patients were divided into three groups by TC levels: group I (TC<4.1 mmol/L), group II (TC 4.1-5.2 mmol/L), and group III (TC>5.2 mmol/L).
  
  
  RESULTS
  The overall mortality was 27.7%. Mortality was higher in patients with low TC levels (47.4%) compared with those with normal and high TC levels (23.0% and 24.1%, respectively). The odds ratio (OR) for short-term death was 2.17 (95% confidence interval [CI] 1.22-3.85) in group I compared with group III, after adjustment for age and gender. This result did not change after adjustment for possible confounders (OR 2.87; 95% CI 1.23-6.68). A similar trend was observed after adjustment for the Oxfordshire classification, age, and gender (OR 1.67; 95% CI 0.83-3.33).
  
  
  CONCLUSIONS
  Short-term mortality following ischemic stroke is higher in older participants with low TC levels, independent of a large number of factors. Low TC levels might be useful in identifying frail older participants at high risk of stroke short-term mortality.
authors.affiliation: 2nd Department of Internal Medicine, University of Ferrara, Italy. gzuliani@hotmail.com
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zuliani
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Atti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Blè
authors.forename: Chella
authors.initials: C
authors.lastname: Vavalle
authors.forename: Filippo
authors.initials: F
authors.lastname: Di Todaro
authors.forename: Cristina
authors.initials: C
authors.lastname: Benedetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpato
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Marinescu
authors.forename: Umberto
authors.initials: U
authors.lastname: Senin
authors.forename: Renato
authors.initials: R
authors.lastname: Fellin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000401:mortality*; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000401:mortality*; D013997:Time Factors
chemical_list: D002784:Cholesterol