Initial serum cholesterol level as a potential marker for post cardiac arrest patient outcomes

Resuscitation. 2020 Jan 1:146:50-55. doi: 10.1016/j.resuscitation.2019.11.003. Epub 2019 Nov 8.

Abstract

Aim: Cholesterol and lipoproteins have many roles during systemic inflammation in critically ill patients. Many previous studies have reported that low levels of cholesterol are associated with poor outcomes in these patients. The aim of this study was to investigate the association of initial total cholesterol with predicting neurologic outcome of post-cardiac arrest patients.

Methods: This was a retrospective observational study of out-of-hospital-cardiac arrest (OHCA) survivors who had serum cholesterol levels at admission. Multivariate regression analysis was performed to investigate total cholesterol and its association with neurologic outcome. Area under receiver operator characteristic curve (AUROC) was assessed and cut off values for predicting good or poor neurologic outcomes were analysed.

Results: A total of 355 patients were analysed. Lower total cholesterol was significantly associated with poor neurologic outcome [OR: 0.99 (95% CI: 0.98-0.99), p < 0.01] in the multivariate analysis. Cholesterol was also useful to screening for poor neurologic outcome [AUROC: 0.70 (95%CI: 0.63-0.77)]. Patients with cholesterol lower than 71 mg/dL had poor neurologic outcome with a specificity of 100%.

Conclusions: Initial cholesterol level is an easily obtained biomarker that showed association with neurologic outcomes of post cardiac arrest patients.

Keywords: Arrest; Cholesterol; Critical illness; Heart; Lipoproteins.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Cardiopulmonary Resuscitation* / adverse effects
  • Cardiopulmonary Resuscitation* / methods
  • Cardiopulmonary Resuscitation* / statistics & numerical data
  • Cholesterol / blood*
  • Critical Illness / epidemiology
  • Diagnostic Tests, Routine / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases / blood
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology
  • Out-of-Hospital Cardiac Arrest* / blood
  • Out-of-Hospital Cardiac Arrest* / complications
  • Out-of-Hospital Cardiac Arrest* / epidemiology
  • Out-of-Hospital Cardiac Arrest* / therapy
  • Outcome Assessment, Health Care / methods
  • Predictive Value of Tests
  • Prognosis
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Time Factors

Substances

  • Biomarkers
  • Cholesterol