Association between Initial Serum Cholesterol Levels and Outcomes of Patients Hospitalized after Out-of-Hospital Cardiac Arrest: A Retrospective Multicenter Registry Study

Purpose: This study aimed to investigate the association between total serum cholesterol levels and outcomes upon discharge in patients after out-of-hospital cardiac arrest (OHCA). Methods: We performed a retrospective observational study using the Korean Cardiac Arrest Resuscitation Consortium (KoCARC) registry. Patients after OHCA whose total serum cholesterol levels were measured within 24 h after arriving at the emergency department were included in the analysis. The association between total serum cholesterol level and neurological outcomes upon discharge and survival to discharge was estimated. Results: Of the 12,321 patients after OHCA enrolled in the registry from October 2015 to June 2020, 689 patients were included. The poor neurologic outcome upon discharge group had a statistically significant lower total serum cholesterol level compared to the good neurologic outcome group (127.5 +/- 45.1 mg/dL vs. 155.1 +/- 48.9 mg/dL, p < 0.001). As a result of multivariate logistic regression analysis, the odds ratio for the neurologic outcome of total serum cholesterol levels was 2.00 (95% confidence interval [CI] 1.01-3.96, p = 0.045). The odds ratio for in-hospital death was 1.72 (95% CI 1.15-2.57, p = 0.009). Conclusions: Low total serum cholesterol levels could be associated with poor neurologic outcomes upon discharge and in-hospital death of patients hospitalized after OHCA.