Abstract: Objective To explore the relationship of blood lipids levels with disease severity and prognosis in the elderly patients with sepsis. Methods A retrospective analysis was conducted on the clinical data of 162 elderly patients with sepsis admitted to Intensive Care Unit (ICU) of the Geriatric Hospital of Nanjing Medical University from January 2015 to January 2022. According to the 28-day mortality, the patients were divided into the survival group (n=104) and the death group (n=58). The clinical data and the levels of blood lipids of the two groups were compared. The correlation of blood lipids levels with inflammatory indicators and severity scores of the condition was analyzed. Receiver operating characteristic(ROC)curve of blood lipids and other clinical indicators in predicting the prognosis of the 28-day death was drawn. The patients were divided into 2 groups according to the cut-off value of the blood lipid index with the largest area under the curve (AUC), and the differences in prognosis were compared between the two groups. Results The levels of male ratio, body mass index (BMI), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in the death group were significantly lower than those in the survival group (P<0.05). The correlation analysis showed that the levels of TC,HDL-C,LDL-C were negatively correlated with Acute Physiology and Chronic Health Evaluation (APACHE Ⅱ)score and the level of procalcitonin(PCT)respectively, and HDL-C was negatively correlated with Sequential Organ Failure Assessmen (SOFA)score as well (P<0.05). ROC curve analysis showed that HDL-C had the highest predictive value (AUC=0.856) for the 28-day mortality, and the best cut-off value was 0.775 mmol/L. The 28-day mortality, incidence rate of multiple organ dysfunction, renal replacement therapy, and multidrug-resistant bacterial infections were significantly higher, and the time of mechanical ventilation and vasoactive drugs usage were longer in the low HDL-C group than those in the high HDL-C group (P<0.05). Conclusions The level of blood lipids, especially HDL-C, can well reflect the severity of elderly patients with sepsis, and it can be used as a good biomarker to predict the prognosis of elderly patients with sepsis.

Key words: aged, sepsis, lipid, prognosis