Serum Total Cholesterol in Nosocomial Infections After Gastrointestinal Surgery

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.