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European Heart Journal 2000 21(9):778-781; doi:10.1053/euhj.1999.1753
Copyright © 2000 by the European Society of Cardiology.
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Medical history of hypercholesterolaemia adversely affects the outcome of out-of-hospital cardiopulmonary resuscitation. The ‘Shahal’ experience in Israel

A Rotha,f1, M Golovnerb, D Gavishc, I Shapiraa, N Malovb, J Senderb, I Alroyb, E Kaplinskid and S Laniadoa

a Departments of Cardiology, The Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
b ‘SHAHAL’ Medical Services, Tel-Aviv, Israel
c Departments of Internal Medicine D, The Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
d Department of Cardiology, the Sheba Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

revised March 16, 1999; accepted May 26, 1999

Abstract

Aims 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.

Methods and Results In this medical facility currently serving 50000 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±1SD) 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.

Key Words: Hypercholesterolaemia, cardiopulmonary resuscitation

f1 Correspondence: Arie Roth, MD, Department of Cardiology, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel-Aviv, 64239, Israel.


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