title: HDL-c levels predict the presence of pleural effusion and the clinical outcome of community-acquired pneumonia.
abstract: OBJECTIVE
  To investigate if HDL cholesterol (HDL-c) could be a biomarker of the degree of severity according to prognostic prediction scores in community-acquired pneumonia (CAP) or the development of clinical complications such as pleural effusion.
  
  
  METHODS
  We included in a retrospective study 107 patients admitted to the hospital that fulfilled diagnostic criteria for CAP between the 30th October 2011 and 1st September 2012. HDL-c levels at admission, CAP prognosis scores (PSI and CURB65) and clinical outcomes were recorded for the study.
  
  
  RESULTS
  Basal HDL-c levels were not statistically different according to prognostics scores neither PSI nor CURB-65. Significantly lower levels of HDL-c were also associated to the development of septic shock and admission to the intensive care unit. HDL-c were inversely correlated with acute phase reactants CRP (r = -0.585, P < 0.001), ESR (r = -0.477, P < 0.001), and leukocytes cell count (r = -0.254, P < 0.009). Patients with pleural effusion showed significant lower levels of HDL-c [28.9 (15.5) mg/dl vs. 44.6 (21.1) mg/dl]; P = 0.007. HDL-c is a good predictor of the presence of pleural effusion in multivariate analyses and using ROC analyses [AUC = 0.712 (0.591-0.834), P = 0.006]. HDL-c levels of 10 mg/dl showed a sensitivity of 97.6 % and a specificity of 82.4 % for the presence of pleural effusion.
  
  
  CONCLUSIONS
  Monitoring HDL-c in CAP is an useful serum marker of acute phase response, clinical outcome and the presence of pleural effusion.
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain ; Oncology Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Saballs
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Parra
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Sahun
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Pellejà
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Feliu
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Vasco
authors.affiliation: Oncology Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gumà
authors.affiliation: Oncology Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Reus, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Borràs
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain ; URLA, CIBERDEM, "Sant Joan" University Hospital (Reus-Spain), IISPV, Universitat Rovira i Virgili, Reus, Spain ; Unitat de Medicina Vascular i Metabolisme (UVASMET), Unitat de Recerca de Lipids i Arteriosclerosis (URLA), "Sant Joan" University Hospital (Reus-Spain), Internal Medicine, IISPV, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Masana
authors.affiliation: Internal Medicine Department, "Sant Joan" University Hospital (Reus-Spain), Institut Investigació Sanitaria Pere Virgili (IISPV), Universitat Rovira i Virgili, Av/Josep Laporte, 1, 43206 Reus, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Castro
keywords: Community-acquired pneumonia; HDL; Pleural effusion