Impaired High-Density Lipoprotein Anti-Oxidant Function Predicts Poor Outcome in Critically Ill Patients |
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Authors: | Lore Schrutka Georg Goliasch Brigitte Meyer Raphael Wurm Lorenz Koller Lukas Kriechbaumer Gottfried Heinz Richard Pacher Irene M Lang Klaus Distelmaier Martin Hülsmann |
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Institution: | 1. Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria;2. Department of Internal Medicine IV, Kaiser-Franz-Josef-Hospital Vienna, Vienna, Austria;3. University Clinic of Orthopedics, Paracelsus Medical University Salzburg, Salzburg, Austria;Kermanshah University of Medical Sciences, ISLAMIC REPUBLIC OF IRAN |
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Abstract: | IntroductionOxidative stress affects clinical outcome in critically ill patients. Although high-density lipoprotein (HDL) particles generally possess anti-oxidant capacities, deleterious properties of HDL have been described in acutely ill patients. The impact of anti-oxidant HDL capacities on clinical outcome in critically ill patients is unknown. We therefore analyzed the predictive value of anti-oxidant HDL function on mortality in an unselected cohort of critically ill patients.MethodWe prospectively enrolled 270 consecutive patients admitted to a university-affiliated intensive care unit (ICU) and determined anti-oxidant HDL function using the HDL oxidant index (HOI). Based on their HOI, the study population was stratified into patients with impaired anti-oxidant HDL function and the residual study population.ResultsDuring a median follow-up time of 9.8 years (IQR: 9.2 to 10.0), 69% of patients died. Cox regression analysis revealed a significant and independent association between impaired anti-oxidant HDL function and short-term mortality with an adjusted HR of 1.65 (95% CI 1.22–2.24; p = 0.001) as well as 10-year mortality with an adj. HR of 1.19 (95% CI 1.02–1.40; p = 0.032) when compared to the residual study population. Anti-oxidant HDL function correlated with the amount of oxidative stress as determined by Cu/Zn superoxide dismutase (r = 0.38; p<0.001).ConclusionImpaired anti-oxidant HDL function represents a strong and independent predictor of 30-day mortality as well as long-term mortality in critically ill patients. |
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