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. 2016 Sep 6;5(1):1491.
doi: 10.1186/s40064-016-3145-x. eCollection 2016.

HDL-c levels predict the presence of pleural effusion and the clinical outcome of community-acquired pneumonia

M Saballs  1 , S Parra  2 , P Sahun  2 , J Pellejà  2 , M Feliu  2 , C Vasco  2 , J Gumà  3 , J L Borràs  3 , L Masana  4 , A Castro  2
Affiliations

HDL-c levels predict the presence of pleural effusion and the clinical outcome of community-acquired pneumonia

M Saballs et al. Springerplus. .

Abstract

Objectives: To investigate if HDL cholesterol (HDL-c) could be a biomarker of the degree of severity according to prognostic prediction scores in community-acquired pneumonia (CAP) or the development of clinical complications such as pleural effusion.

Methods: We included in a retrospective study 107 patients admitted to the hospital that fulfilled diagnostic criteria for CAP between the 30th October 2011 and 1st September 2012. HDL-c levels at admission, CAP prognosis scores (PSI and CURB65) and clinical outcomes were recorded for the study.

Results: Basal HDL-c levels were not statistically different according to prognostics scores neither PSI nor CURB-65. Significantly lower levels of HDL-c were also associated to the development of septic shock and admission to the intensive care unit. HDL-c were inversely correlated with acute phase reactants CRP (r = -0.585, P < 0.001), ESR (r = -0.477, P < 0.001), and leukocytes cell count (r = -0.254, P < 0.009). Patients with pleural effusion showed significant lower levels of HDL-c [28.9 (15.5) mg/dl vs. 44.6 (21.1) mg/dl]; P = 0.007. HDL-c is a good predictor of the presence of pleural effusion in multivariate analyses and using ROC analyses [AUC = 0.712 (0.591-0.834), P = 0.006]. HDL-c levels of 10 mg/dl showed a sensitivity of 97.6 % and a specificity of 82.4 % for the presence of pleural effusion.

Conclusion: Monitoring HDL-c in CAP is an useful serum marker of acute phase response, clinical outcome and the presence of pleural effusion.

Keywords: Community-acquired pneumonia; HDL; Pleural effusion.

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Figures

Fig. 1
Fig. 1
Differences between HDL-c levels regarding the presence of ICU admission, shock, pleural effusion or empyema
Fig. 2
Fig. 2
Bivariate correlations between HDL-c levels and leukocyte cell count, ESR and CRP
Fig. 3
Fig. 3
Linear regression analyses. Variables that predict HDL levels in patients with CAP
Fig. 4
Fig. 4
Logistic regression analyses. Variables that predict the presence of pleural effusion
Fig. 5
Fig. 5
ROC curve. HDL-chol levels predicts pleural effusion
See this image and copyright information in PMC

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