THE PROGNOSTIC VALUE OF HYPOCHOLESTEROLEMIA IN HOSPITALIZED-PATIENTS

Clinical observations show that severe illness often leads to hypochol esterolemia. To verify this finding and to define the relationship bet ween serum cholesterol and a patient's prognosis, a study was conducte d in two large hospital populations. Of 24,000 and 61,463 adult patien ts (populations I and II) an average of 3.8% and 3.6% died in hospital , respectively. The mean serum cholesterol levels of patients who died was significantly lower than that of those who survived (163.6 mg/dl versus 217.8 mg/dl; P < 0.0001). The average cholesterol of surviving patients was similar to that of 6,543 healthy controls. During hospita lization serum cholesterol levels of less than or equal to 100 mg/dl w ere encountered in 1.2% and 3.6% of patients of populations I and II, respectively. The mortality of these hypocholesterolemic patients was about tenfold higher than average and showed a strong, inverse, linear relationship with serum cholesterol concentrations. Patients whose se rum cholesterol level dropped to less than 45 mg/dl did not survive. T hese data show that in severely ill patients serum cholesterol may dec line to very low concentrations, and the prognosis is reflected by the degree of hypocholesterolemia, which thus may serve as a clinically u seful prognostic parameter.