High-density lipoprotein 2b combined with Sequential Organ Failure Assessment score as a novel prognostic indicator for patients with sepsis

Abstract Background Sepsis is a serious disease and patients have high risk of short-term mortality. Despite extensive research, there are no simple and reliable tools for predicting outcomes. Purpose To assess the value of the combined use of high-density lipoprotein 2b (HDL2b) level and Sequential Organ Failure Assessment (SOFA) score in predicting short-term mortality from sepsis. Materials and Methods Forty-seven sepsis patients and 11 non-septic controls who were admitted to an intensive care unit (ICU) from January 2020 to December 2021 were examined. HDL2b as a percentage of total HDL-C and SOFA score were recorded on the first day after admission. The primary endpoint was 28-day mortality and the secondary outcome was total in-hospital mortality. Results Compared to non-septic controls, septic patients had a lower HDL2b level (10.95% [8.95, 12.96] vs. 23.78% [14.53, 29.16], p < 0.001). Among sepsis patients, the HDL2b level was lower in non-survivors than survivors (6.74% [4.63, 8.08] vs. 11.78 [7.20, 13.40], p = 0.002]. The areas under the receiver operating characteristic curves for predicting 28-day mortality were 0.755 for HDL2b, 0.782 for SOFA, and 0.806 for HDL2b + SOFA. Multivariate analyses indicated that HDL2b (adjusted odds ratio [aOR]: 0.780 [0.621, 0.978]), SOFA (aOR: 1.299 [0.927, 1.820]), and HDL2b + SOFA (aOR: 8.958 (1.037, 85.199]) were significant predictors of 28-day mortality. Patients with higher HDL2b + SOFA scores had higher rates of 28-day and overall in-hospital mortality. Conclusions Sepsis patients have reduced levels of HDL2b. HDL2b + SOFA score was a reliable predictor of 28-day and overall in-hospital mortality in sepsis patients.