The association between blood glucose levels on arrival at the hospital and patient outcomes after out-of-hospital cardiac arrest: A multicenter cohort study

被引:1
作者
Taira, Takuya [1 ,2 ]
Inoue, Akihiko [1 ,3 ]
Kuroda, Yasuhiro [2 ]
Oosuki, Gentoku [1 ]
Suga, Masafumi [1 ]
Nishimura, Takeshi [1 ]
Ijuin, Shinichi [1 ]
Ishihara, Satoshi [1 ]
机构
[1] Hyogo Emergency Med Ctr, Dept Emergency & Crit Care Med, Kobe, Hyogo, Japan
[2] Kagawa Univ, Fac Med, Grad Sch Med, Takamatsu, Kagawa, Japan
[3] Hyogo Emergency Med Ctr, Dept Emergency & Crit Care Med, 1-3-1 Wakinohamakaigandori,Chuo Ku, Kobe, Hyogo 6510073, Japan
关键词
Mortality; Survival; Cardiac arrest; Stress hyperglycemia; Neurological outcome; Prognostic factor; EUROPEAN-RESUSCITATION-COUNCIL; CARDIOPULMONARY-RESUSCITATION; RECOMMENDED GUIDELINES; HYPERGLYCEMIA; ADMISSION; SURVIVAL; MORTALITY; RECOVERY; STRESS;
D O I
10.1016/j.ajem.2023.12.004
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: This study aimed to investigate the association between blood glucose levels on arrival at the hospital and 1-month survival and favorable neurological outcomes in patients with OHCA using a large Japanese dataset.Methods: This study was a secondary analysis of data from the JAAM-OHCA Registry. Adult (>= 18 years) patients with witnessed OHCA transported to emergency departments and registered in the database from June 2014 to December 2019 were included in the study. The primary and secondary endpoints were 1-month survival and 1-month favorable neurological outcomes (Glasgow-Pittsburgh Cerebral Performance Category score 1 or 2), respectively. Patients were categorized into the following four groups based on blood glucose levels on arrival at the hospital: <80 mg/dL, 80-179 mg/dL, 180-299 mg/dL, and >= 300 mg/dL.Results: This study included 11,387 patients. Survival rates were 1.3%, 3.1%, 7.0%, and 5.7% in the <80 mg/dL, 80-179 mg/dL, 180-299 mg/dL, and >= 300 mg/dL blood glucose groups, respectively. The rates of favorable neurological outcomes in each group were 0.4%, 1.5%, 3.3%, and 2.5%, respectively. Multivariable analysis showed that 180-299 mg/dL glucose was significantly associated with 1-month survival and favorable neurological outcomes compared with 80-179 mg/dL glucose (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.34-2.31; p < 0.001 and OR, 1.52; 95 % Cl, 1.02-2.25; p = 0.035, respectively). In this study, blood glucose levels with the best outcomes likely ranged from 200 to 250 mg/dL based on the cubic spline regression model.Conclusions: Blood glucose level of 180-299 mg/dL on arrival at the hospital was significantly associated with 1-month survival and favorable neurological outcomes compared to blood glucose level of 80-179 mg/dL in patients with OHCA.(c) 2023 Elsevier Inc. All rights reserved.
引用
收藏
页码:46 / 52
页数:7
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