title: Cholesterol rather than procalcitonin or C-reactive protein predicts mortality in patients with infection.
abstract: Serum cholesterol procalcitonin (PCT) and C-reactive protein (CRP) levels were measured consecutively in 76 critically ill patients at admission to the intensive care unit. The presence of infection was defined according to the CDC (Centers for Disease Control and Prevention) criteria; in-house mortality, underlying diseases, and severity of sepsis were monitored. Nonsurvivors had significantly lower cholesterol levels compared with survivors (69 mg/dL [range, 37-88 mg/dL] vs. 96 mg/dL [range, 71-132 mg/dL], P = 0.006) whereas no significant differences were noted for serum PCT and CRP levels. In a cohort of patients with cholesterol levels of 50 mg/dL or less, 82% did not survive as compared with patients with cholesterol levels of 100 mg/dL or greater (mortality, 21%). In a control group without infection, no difference of cholesterol, PCT, or CRP was found between survivors and nonsurvivors. Our data show that low cholesterol levels in patients with infectious disease have a prognostic value and may be useful markers to identify high-risk patients already at admission.
authors.affiliation: *Medical Central Laboratories; †Clinic of Anesthesiology and Intensive Care Medicine, Academic Teaching Hospital; and ‡Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; and §Department of Clinical Chemistry, University Hospital Großhadern, Munich, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Biller
authors.forename: Peter
authors.initials: P
authors.lastname: Fae
authors.forename: Reinhard
authors.initials: R
authors.lastname: Germann
authors.forename: Heinz
authors.initials: H
authors.lastname: Drexel
authors.forename: Autar K
authors.initials: AK
authors.lastname: Walli
authors.forename: Peter
authors.initials: P
authors.lastname: Fraunberger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D002784:Cholesterol; D015740:Calcitonin Gene-Related Peptide