# A Low Level of High-Density Lipoprotein Cholesterol Predicts All-Cause Mortality Within 30 Days in Hospitalized Elderly Patients

## TL;DR

Low HDL cholesterol levels in elderly hospitalized patients predict higher 30-day mortality, suggesting it could help assess risk and guide care.

## Contribution

Identifies a specific HDL-C cut-off value as a mortality predictor in elderly hospitalized patients.

## Key findings

- Low HDL-C levels at admission were associated with increased 30-day all-cause mortality in elderly patients.
- The optimal HDL-C cut-off for predicting mortality was 31 mg/dL, lower than standard reference values.
- HDL-C showed a statistically significant hazard ratio in multivariate analysis for mortality risk.

## Abstract

Background: Whether low levels of high-density lipoprotein cholesterol (HDL-C) in the blood determine mortality has not been fully elucidated among elderly patients. It is thus a particular concern to see the predictive implication of HDL-C for post-hospitalized mortality in an elderly population.

Methods: This study was planned to investigate the HDL-C level at admission to a hospital in 493 patients of ≥70 years of age. The outcome was death from any cause within the first 30 days after admission. Cox proportional hazards models were used for the analyses. In addition, the time-dependent (follow-up period) receiver operating characteristic (ROC) curve analysis of HDL-C was performed for all-cause mortality.

Results: The median age of patients was 89 years, and the proportion of male patients was 41%. The median HDL-C level at admission was 41 mg/dL. Deaths occurred in 89 patients (18%) during a median follow-up period of 27 days. In a multivariate model, the HDL-C showed a hazard ratio of 0.977 (95% confidence interval (CI) 0.955-0.998). The results of the ROC curve analysis on all-cause mortality demonstrated that the area under the curve value was 0.67 (95% CI 0.60-0.74) and the cut-off value of HDL-C was 31 mg/dL.

Conclusions: A low HDL-C level at admission was a predictor of all-cause mortality within 30 days in hospitalized elderly patients. The cut-off value of HDL-C was deemed to be low in considering the reference value in daily practice. When elderly patients are admitted, the HDL-C level could be the focus of attention for the prediction of the prognosis and disease management.