Analysis of Prognostic Significance of Serum HDL Level in Patients of Sepsis Admitted to a Tertiary Care Hospital of Southern Odisha

Author(s): Umashankar Mishra1, Sudhansu Sekhar Pradhan2, Srabani Pradhan3

Sepsis is the body’s overwhelming and life-threatening response to infection that
may cause tissue damage, organ failure and death. High density lipoproteins (HDL)
are relevant players in both innate and adaptive immunity involved in response to
infection. So, with this reference and limited number of studies showing
association of prognosis with high-density lipoprotein level in sepsis patients, this
study was done to find out the changes in HDL level of sepsis patients and its
association with prognosis.
This is a prospective hospital-based study done on 210 patients with sepsis
admitted in medicine ward and intensive care unit (ICU) of M.K.C.G Medical
College, Odisha from November 2017 to November 2019. Patient’s included in
study are based on initial assessment by quick SOFA (Qsofa) scoring system. At
the time of admission, patient’s clinical history, relevant biochemical parameters
were noted and detail clinical examination was done. All the patients were followed
prospectively during their entire course of stay. Serum HDL was done on the day
of admission and was repeated on day 4 and on day of discharge. Outcome was
measured in terms of survival and duration of hospital stay.
Out of 210 patients, 168 (80 %) survived and 42 (20 %) cases died. Survival rate
was significantly higher in patients admitted to ward than those in ICU. HDL level
on day 1 showed significant inverse correlation with SOFA score. Inverse
correlation was also observed between the duration of stay in hospital and HDL
on day 1. Significantly higher level of HDL was observed in patients who survived
than non-survivors. In cases which survived, a statistically significant increase was
observed in HDL level from day 1 to day of discharge.
HDL cholesterol on day of admission can be viewed as a significant predictor of
mortality in patients of sepsis.