Serum total cholesterol in nosocomial infections after gastrointestinal surgery.

Abstract

The profile of lipoprotein expression in plasma is altered by surgical stress. The role of total cholesterol in postsurgical patients with nosocomial infection remains unknown. We validated the data from 1,031 patients undergoing open gastrointestinal surgery between December 2006 and November 2008 using a clinical database available from Iizuka Hospital. Biochemical parameters related to plasma total cholesterol were measured. Various parameters predictive of the conditions--e.g., surgical incisional infection, organ space infection, pneumonia within 30 days after surgery--were assessed by multiple logistic regression analyses. The most frequent infection was surgical incisional infection. Serum total cholesterol levels-(1) lowest quartile (<159 mg/dl) vs. reference (200-239 mg/dl): adjusted odds ratio (OR) 5.39, 95% confidence interval (CI) 2.28-12.76; (2) second lowest quartile (160-199 mg/dl) vs. reference: OR 2.76, 95% CI 1.01-7.53-showed a significant inverse relation with surgical incisional infection. Both lowest and highest total cholesterol levels were associated with a higher risk of surgical incisional infection and organ space infection. None of the patients with high (> or =200 mg/dl) total cholesterol levels suffered from pneumonia. Total cholesterol levels appeared to be one of the risk factors for surgical incisional infection and pneumonia. Patients with borderline blood cholesterol levels (200-239 mg/dl) seemed to be the best candidates for operation.