Medical history of hypercholesterolaemia adversely affects the outcome of out-of-hospital cardiopulmonary resuscitation - The 'Shahal' experience in Israel

Aims To evaluate the impact selected risk factors for cardiac death may hav e on the success rate in a large cohort of subscribers to 'SHAHAL' who were resuscitated from out-of-hospital cardiac arrest. Methods and Results In this medical facility currently serving 50 000 subsc ribers, data were prospectively gathered from between 1987-1998. The inform ation retrieved from the patients' medical records included a medical histo ry of hypertension, diabetes, hypercholesterolaemia (>220.mg.dl(-1)) smokin g, angina, previous myocardial infarction, and congestive heart failure. A total of 998 patients aged 74 +/- 12 years (mean +/- 1 SD) were included. D eath was announced at the scene for 659 (66%) victims, while 339 (34%) pati ents were taken to hospital. Of these 140 (14% of the total cohort) survive d and were discharged from the hospital. A comparison of various selected p arameters between survivors and non-survivors of resuscitation revealed tha t survivors were younger, had a higher rate of pulseless ventricular tachyc ardia/ventricular fibrillation, mon were among the arrests witnessed by the 'SHAHAL' team, and that more had a shorter time lag to initiation of cardi opulmonary resuscitation than non-survivors. None of the studied risk facto rs predicted the outcome of cardiopulmonary resuscitation, with the excepti on of hypercholesterolaemia, which carried a significantly worse prognosis for cardiopulmonary resuscitation (P=0.009). Conclusions A medical history of hypercholesterolaemia appears to be an imp ortant risk factor which adversely affects the outcome of cardiopulmonary r esuscitation. (C) 2000 The European Society of Cardiology.