Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;8(1):e000757.
doi: 10.1136/bmjresp-2020-000757.

Hyperlipidaemia and mortality among patients hospitalised with pneumonia: retrospective cohort and propensity score matched study

Mohammed Yousufuddin  1 , Umesh M Sharma  2 , Sumit Bhagra  3 , Mohammad Hassan Murad  4
Affiliations

Hyperlipidaemia and mortality among patients hospitalised with pneumonia: retrospective cohort and propensity score matched study

Mohammed Yousufuddin et al. BMJ Open Respir Res. 2021 Mar.

Abstract

Objective: To characterise the potential association of hyperlipidaemia (HLP) versus no HLP with all-cause mortality among patients hospitalised for pneumonia.

Design: Propensity score matched retrospective study.

Participants: The study cohort consisted of consecutive 8553 adults hospitalised at a large academic centre with a discharge diagnosis of pneumonia from 1996 through 2015, followed until death or end of the study period, 17 August 2017.

Outcomes: The outcome was HR for mortality at 28 days and in the long term in patients with pneumonia with concurrent HLP compared with those with no HLP. We first constructed multivariable Cox proportional regression models to estimate the association between concurrent HLP versus no HLP and mortality after pneumonia hospitalisation for the entire cohort. We then identified 1879 patients with pneumonia with concurrent HLP and propensity score matched in a 1:1 ratio to 1879 patients with no HLP to minimise the imbalance from measured covariates for further analysis.

Results: Among 8553 unmatched patients with pneumonia, concurrent HLP versus no HLP was independently associated with lower mortality at 28 days (HR 0.52, 95% CI 0.41 to 0.66) and at a median follow-up of 3.9 years (HR 0.75, 95% CI 0.70 to 0.80). The risk difference in mortality was consistent between 1879 propensity score matched pairs both at 28 days (HR 0.65, 95% CI 0.49 to 0.86) and at a median follow-up of 4 years (HR 0.88, 95% CI 0.81 to 0.96). In the subgroup of patients with clinically measured low-density lipoprotein cholesterol (LDL-C), graded inverse associations between LDL-C levels and mortality were found in both unmatched and matched cohorts.

Conclusions: Among hospitalised patients with pneumonia, a diagnosis of HLP is protective against both short-term and long-term risk of death after adjustment for other major contributors to mortality in both unmatched and propensity score matched cohorts. These findings should be further investigated.

Keywords: pneumonia.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Strengthening the Reporting of Observational Studies in Epidemiology flow diagram of selection of the final study cohort. ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification.
Figure 2
Figure 2
(A) Unmatched cohort (n=8553) and (B) propensity score matched cohort (n=1879 pairs).
Figure 3
Figure 3
Kaplan-Meier mortality estimates comparing pneumonia patients with and with no concurrent hyperlipidaemia and by low density lipoprotein cholesterol (LDL-C) quartiles.A) unmatched original cohort patients with and with no hyperlidaemia, B) unmatched original cohort patients by LDL-C quartiles, C) propensity-score matched cohort patients with and with no hyperlidaemia, D) propensity-score matched cohort patients by LDL-C quartiles.
See this image and copyright information in PMC

References

    1. Yusuf S, Hawken S, Ounpuu S, et al. . Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937–52. 10.1016/S0140-6736(04)17018-9 - DOI - PubMed
    1. LaRosa JC, Hunninghake D, Bush D, et al. . The cholesterol facts. A summary of the evidence relating dietary fats, serum cholesterol, and coronary heart disease. A joint statement by the American heart association and the National heart, lung, and blood Institute. The task force on cholesterol issues, American heart association. Circulation 1990;81:1721–33. 10.1161/01.CIR.81.5.1721 - DOI - PubMed
    1. Stamler J, Wentworth D, Neaton JD. Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? findings in 356,222 primary screenees of the multiple risk factor intervention trial (MRFIT). JAMA 1986;256:2823–8. - PubMed
    1. Baigent C, Blackwell L, et al. , Cholesterol Treatment Trialists’ (CTT) Collaboration . Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 2010;376:1670–81. 10.1016/S0140-6736(10)61350-5 - DOI - PMC - PubMed
    1. Mihaylova B, Emberson J, Cholesterol Treatment Trialists' (CTT) Collaborators, et al. . The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012;380:581–90. 10.1016/S0140-6736(12)60367-5 - DOI - PMC - PubMed