title: Medical history of hypercholesterolaemia adversely affects the outcome of out-of-hospital cardiopulmonary resuscitation; the 'Shahal' experience in Israel.
abstract: OBJECTIVE
  To evaluate the impact selected risk factors for cardiac death may have on the success rate in a large cohort of subscribers to 'SHAHAL' who were resuscitated from out-of-hospital cardiac arrest.
  
  
  RESULTS
  In this medical facility currently serving 50 000 subscribers, data were prospectively gathered from between 1987-1998. The information retrieved from the patients' medical records included a medical history of hypertension, diabetes, hypercholesterolaemia (>220.mg. dl(-1)) smoking, angina, previous myocardial infarction, and congestive heart failure. A total of 998 patients aged 74+/-12 years (mean+/-1 SD) were included. Death was announced at the scene for 659 (66%) victims, while 339 (34%) patients were taken to hospital. Of these 140 (14% of the total cohort) survived and were discharged from the hospital. A comparison of various selected parameters between survivors and non-survivors of resuscitation revealed that survivors were younger, had a higher rate of pulseless ventricular tachycardia/ventricular fibrillation, more were among the arrests witnessed by the 'SHAHAL' team, and that more had a shorter time lag to initiation of cardiopulmonary resuscitation than non-survivors. None of the studied risk factors predicted the outcome of cardiopulmonary resuscitation, with the exception of hypercholesterolaemia, which carried a significantly worse prognosis for cardiopulmonary resuscitation (P=0.009).
  
  
  CONCLUSIONS
  A medical history of hypercholesterolaemia appears to be an important risk factor which adversely affects the outcome of cardiopulmonary resuscitation.
authors.affiliation: Departments of Cardiology, The Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Roth
authors.forename: M
authors.initials: M
authors.lastname: Golovner
authors.forename: D
authors.initials: D
authors.lastname: Gavish
authors.forename: I
authors.initials: I
authors.lastname: Shapira
authors.forename: N
authors.initials: N
authors.lastname: Malov
authors.forename: J
authors.initials: J
authors.lastname: Sender
authors.forename: I
authors.initials: I
authors.lastname: Alroy
authors.forename: E
authors.initials: E
authors.lastname: Kaplinski
authors.forename: S
authors.initials: S
authors.lastname: Laniado
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications* / Q000453:epidemiology; D007557:Israel / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome