CHARACTERISTICS AND OUTCOMES OF HOSPITALIZED OLDER PATIENTS WHO DEVELOP HYPOCHOLESTEROLEMIA

Objectives: This research project was undertaken to determine the clinical characteristics, lipoprotein abnormalities, and outcomes of older hospitalized patients who develop hypocholesterolemia. Methods: The project had two parts: (1) a retrospective, case-control study of 50 hospitalized patients greater-than-or-equal-to 65 years old whose serum cholesterol was normal on admission (greater-than-or-equal-to 160 mg/dL) and fell to less-than-or-equal-to 120 mg/dL during hospitalization; (2) a laboratory study of lipoproteins in 17 hospitalized patients greater-than-or-equal-to 65 years old whose cholesterol was normal on admission but fell to less-than-or-equal-to 120 mg/dL during hospitalization. Results: Case-control Study-Nine percent of patients greater-than-or-equal-to 65 years old developed hypocholesterolemia while in the hospital, and these patients were more likely than controls to have undergone surgery and to have nothing by mouth for 5 days or longer. Cases had a longer length of stay, more complications, and were slightly more likely to die in the hospital than controls. Laboratory Study-Hypocholesterolemic patients had low concentrations of all lipoproteins (VLDL, LDL, HDL), and the LDL and HDL were enriched in triglyceride and depleted of cholesterol ester. Conclusion: Acquired hypocholesterolemia is a common finding in hospitalized older patients and is associated with poor outcomes. Patients who became hypocholesterolemic in the hospital had both a low concentration of lipoprotein particles and abnormalities in lipoprotein particle composition.