Cholestrol role as a marker for organ dysfunction after thoracoabdominal surgeries

Abstract

Various studies of low HDL, high LDL, and total cholesterol have been identified as independent variables of cardiovascular events. Therefore, evaluation of these factors is usually performed in hospitalized patients. Hypocholesterolemia is a variable of mortality in patients with renal failure and high age. Studies on the use of cholesterol in surgery as a prognostic marker are scarce. HDL also has antioxidant, anti-thrombotic, anti-apoptotic effects in addition to its central role in reverse cholesterol transport. The anti-inflammatory effects of HDL have been extensively studied, affecting both the local immune system (such as adhesion molecules to the epithelium) and the systemic immune system (such as adhesion molecules and secretion of cytokines by monocytes). Cholesterol level assessment along with clinical evaluation of the patient can help in early diagnosis of organ failure after abdominal surgery. Since studies on the prognostic value of cholesterol in surgical patients are limited, so in this study we evaluated the value of cholesterol in determining the probability of organ dysfunction after thoracic abdominal surgery. Methods: All patients who underwent thoracodabdominal surgery during the study (24 months) were enrolled in this study. Blood samples were taken from all patients during the first two days of admission and total cholesterol, HDL, LDL, TG, Hb , Cr, BUN, Ca and Alb were evaluated in the laboratory of Imam Reza Hospital. Results: Based on logistic regression and linear regression it was found that the results of our study showed that by increasing one unit total cholesterol in patients undergoing abdominal-thoracic surgery, the chances of kidney, liver, lung, heart and blood disorders were increased. Significantly increased and length of hospital stay, length of stay in ICU, duration of mechanical ventilation, and use of vasopressor were significantly increased but the increased chance of developing brain failure was not significant in these patients.