Survival of patients with and without diabetes following out-of-hospital cardiac arrest: A nationwide Danish study

被引:13
作者
Mohr, Grimur Hognason [1 ]
Sondergaard, Kathrine B. [1 ]
Pallisgaard, Jannik L. [1 ]
Moller, Sidsel Gamborg [1 ]
Wissenberg, Mads [1 ,2 ]
Karlsson, Lena [1 ,2 ]
Hansen, Steen Moller [3 ]
Kragholm, Kristian [3 ,4 ,5 ]
Kober, Lars [6 ]
Lippert, Freddy [2 ]
Folke, Fredrik [1 ,2 ]
Vilsboll, Tina [7 ,8 ]
Torp-Pedersen, Christian [3 ,5 ,9 ]
Gislason, Gunnar [1 ,8 ,10 ,11 ]
Rajan, Shahzleen [1 ]
机构
[1] Univ Copenhagen, Herlev & Gentofte Hosp, Dept Cardiol, Gentofte, Denmark
[2] Univ Copenhagen, Emergency Med Serv Copenhagen, Copenhagen, Denmark
[3] Aalborg Univ Hosp, Unit Epidemiol & Biostat, Aalborg, Denmark
[4] Hjorring Reg Hosp, Dept Cardiol, Hjorring, Denmark
[5] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark
[6] Univ Copenhagen, Rigshosp, Heart Ctr, Copenhagen, Denmark
[7] Univ Copenhagen, Steno Diabet Ctr Copenhagen, Clin Metab Physiol, Copenhagen, Denmark
[8] Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark
[9] Aalborg Univ, Dept Hlth Sci & Technol, Aalborg, Denmark
[10] Univ Southern Denmark, Natl Inst Publ Hlth, Copenhagen, Denmark
[11] Danish Heart Fdn, Copenhagen, Denmark
关键词
Diabetes; out-of-hospital cardiac arrest; survival; return of spontaneous circulation; bystander cardiopulmonary resuscitation; pre-hospital resuscitation; CARDIOVASCULAR-DISEASE; PUBLIC LOCATIONS; GLUCOSE LEVEL; RISK; MELLITUS; HYPOGLYCEMIA; OUTCOMES; ASSOCIATION; PREVALENCE; MANAGEMENT;
D O I
10.1177/2048872618823349
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background:Research regarding out-of-hospital cardiac arrest (OHCA) survival of diabetes patients is sparse and it remains unknown whether initiatives to increase OHCA survival benefit diabetes and non-diabetes patients equally. We therefore examined overall and temporal survival in diabetes and non-diabetes patients following OHCA. Methods: Adult presumed cardiac-caused OHCAs were identified from the Danish Cardiac Arrest Registry (2001-2014). Associations between diabetes and return of spontaneous circulation upon hospital arrival and 30-day survival were estimated with logistic regression adjusted for patient- and OHCA-related characteristics. Results: In total, 28,955 OHCAs were included of which 4276 (14.8%) had diabetes. Compared with non-diabetes patients, diabetes patients had more comorbidities, same prevalence of bystander-witnessed arrests (51.7% vs. 52.7%) and bystander cardiopulmonary resuscitation (43.2% vs. 42.0%), more arrests in residential locations (77.3% vs. 73.0%) and were less likely to have shockable heart rhythm (23.5% vs. 27.9%). Temporal increases in return of spontaneous circulation and 30-day survival were seen for both groups (return of spontaneous circulation: 8.8% in 2001 to 22.3% in 2014 (diabetes patients) vs. 7.8% in 2001 to 25.7% in 2014 (non-diabetes patients); and 30-day survival: 2.8% in 2001 to 9.7% in 2014 vs. 3.5% to 14.8% in 2014, respectively). In adjusted models, diabetes was associated with decreased odds of return of spontaneous circulation (odds ratio 0.74 (95% confidence interval 0.66-0.82)) and 30-day survival (odds ratio 0.56 (95% confidence interval 0.48-0.65)) (interaction with calendar year p=0.434 and p=0.243, respectively). Conclusion:No significant difference in temporal survival was found between the two groups. However, diabetes was associated with lower odds of return of spontaneous circulation and 30-day survival.
引用
收藏
页码:599 / 607
页数:9
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