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Clinical Chemistry 46: 1114-1120, 2000;
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(Clinical Chemistry. 2000;46:1114-1120.)
© 2000 American Association for Clinical Chemistry, Inc.

Articles

Prognostic Significance of Low Serum Cholesterol after Cardiothoracic Surgery

Axel Stachon1,a, Andreas Böning2, Heike Weisser1, Axel Laczkovics2, Guido Skipka3 and Michael Krieg1

1 Institute of Clinical Chemistry, Transfusion and Laboratory Medicine,
2 Clinic of Cardiac and Thoracic Surgery, and
3 Department of Biometry, Ruhr-University, Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany.
a Author for correspondence. Fax 49-234-302-6614; e-mail Axel.Stachon{at}ruhr-uni-bochum.de

Background: The precise prognostic significance of critically low cholesterol concentrations in patients undergoing cardiothoracic surgery is unknown.

Methods: In a retrospective case-control study, we analyzed the database of 2074 patients, of whom 87 died postoperatively in hospital. All patients underwent cardiothoracic surgery using a heart-lung machine. Age, sex, body mass index, preoperative ejection fraction, smoking, diabetes mellitus, type of operation, emergency surgery, renal deficiency, pulmonary hypertension, and endocarditis were considered together with serum concentrations of cholesterol, C-reactive protein, alanine aminotransferase, and triglycerides. The statistics included sensitivity, specificity, predictive value, odds ratio, and the ROC curve.

Results: Cholesterol decreased sharply immediately after surgery in both the deceased and the survivors. In the deceased, the mean cholesterol concentration (± SE) remained rather low between days 4 and 7 after surgery [2.46 ± 0.16 mmol/L (95 ± 6 mg/dL)]. In the survivors at that time, the mean cholesterol concentration was significantly (P <0.001) higher [4.37 ± 0.03 mmol/L (169 ± 1 mg/dL)]. The positive predictive value of a critically low cholesterol concentration [<3.10 mmol/L (<120 mg/dL)] was 25.4%, increasing to 66.6% at a cutoff value of 1.55 mmol/L (60 mg/dL). The odds ratio under those circumstances was 15.5, and the area under curve (C-statistic) was 0.90.

Conclusions: The cholesterol concentration between days 4 and 7 after cardiothoracic surgery possesses a high prognostic significance in terms of in-hospital mortality.




The following articles in journals at HighWire Press have cited this article:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
L. Mascitelli, F. Pezzetta, and M. R. Goldstein
Does hypercholesterolemia improve operative outcomes in patients without coronary artery disease who undergo cardiac surgery?
J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 256 - 256.
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