Serum cholesterol as a predictor of mortality among the elderly patients with pneumonia in the emergency department

Abstract Background Reduced cholesterol levels are associated with poor outcomes in critically ill patients. However, the effect of reduced cholesterol levels on the prognosis of patients with community-acquired pneumonia (CAP) is unclear. This study aimed to investigate the association between serum total cholesterol levels and the clinical outcomes of elderly patients with CAP. Methods This was a retrospective observational study that included elderly (≥65 years) CAP patients hospitalized through emergency department between January 2016 and December 2019. We collected their baseline characteristics and laboratory data, including total cholesterol levels at the time of admission. Univariate and multivariate analyses were performed to determine the association between total cholesterol levels and 14-day in-hospital mortality. Results A total of 380 patients were included. The overall 14-day in-hospital mortality rate was 12.37%. Survivors had higher total cholesterol levels than non-survivors (median, 125 mg/dL; interquartile range [IQR], 102–151 mg/dL versus median, 100 mg/dL; IQR, 83–126 mg/dL; p  Conclusions A decreased level of total cholesterol was associated with increased short-term mortality in elderly patients with CAP. Initial total cholesterol levels may be a useful biomarker to predict the outcome of patients with CAP.