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Total Cholesterol, HDL-Cholesterol, and Risk of Nosocomial Infection: A Prospective Study in Surgical Patients

Published online by Cambridge University Press:  02 January 2015

Miguel Delgado-Rodríguez ,
Marcelino Medina-Cuadros ,
Gabriel Martínez-Gallego  and
María Sillero-Arenas
Miguel Delgado-Rodríguez*
Affiliation:
Division of Preventive Medicine and Public Health, School of Medicine, University of Cantabria, Santander, Jaén, Spain
Marcelino Medina-Cuadros
Affiliation:
General Surgery Service, General Hospital Ciudad de Jaén, Jaén, Spain
Gabriel Martínez-Gallego
Affiliation:
General Surgery Service, General Hospital Ciudad de Jaén, Jaén, Spain
María Sillero-Arenas
Affiliation:
Division of Health Programs, Provincial Office for Health, Jaén, Spain
*
Division of Preventive Medicine and Public Health, School of Medicine, University of Cantabria, Avenida Cardenal Herrera Oria s/n, 39011-Santander, Spain
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Abstract

Objective:

To study the relationship between serum high-density lipoprotein cholesterol (HDL-C), total serum cholesterol, and nosocomial infection in patients undergoing general surgery.

Design:

Prospective cohort study, with an extended follow-up to 1 month after hospital discharge.

Setting:

The general surgery service of a tertiary hospital.

Main Outcome Measure:

Nosocomial infection, mainly surgical-site infection (SSI), urinary tract infection, respiratory tract infection (RTI), and bacteremia.

Patients:

1,267 surgery patients aged 10 to 92 years.

Results:

182 subjects acquired 194 nosocomial infections, a cumulative incidence of 14.5%; most (116, 62.3%) were postoperative wound infections. There was an increase in infection risk at low levels of HDL-C, and both low and high total cholesterol levels. After adjusting simultaneously for several confounders, including total cholesterol, low levels of HDL-C (≤20 mg/dL) yielded an odds ratio (OR) of 2.2 (95% confidence interval [CI95], 0.6-7.9) for SSI and an OR of 10.3 (CI95, 0.7-151.5) for RTI. Otherwise, no trend was observed between HDL-C levels and infection risk, and no increased risk of nosocomial infection was observed for HDL-C values in the range of 21 to 49 mg/dL. Serum cholesterol showed a U-shaped relationship with nosocomial infection risk. Both low levels (below 102 mg/dL) and high levels (above 290 mg/dL) of total cholesterol were associated with a higher risk of SSI (mainly those caused by gram-negative bacteria) and RTI in comparison with the reference group (139-261 mg/dL).

Conclusions:

Serum HDL-C and total cholesterol seem to be associated with the risk of nosocomial infection in surgical patients

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 1 , January 1997 , pp. 9 - 18
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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