The association between blood glucose levels on arrival at the hospital and patient outcomes after out-of-hospital cardiac arrest: A multicenter cohort study - 12/02/24
, Yasuhiro Kuroda, M.D., Ph.D. b, Gentoku Oosuki, M.D. a, Masafumi Suga, M.D. a, Takeshi Nishimura, M.D., Ph.D. a, Shinichi Ijuin, M.D. a, Satoshi Ishihara, M.D., Ph.D. aAbstract |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The association between blood glucose levels and outcomes in OHCA patients has not been thoroughly examined. |
• | Mild-to-moderate hyperglycemia on arrival at the hospital was significantly associated with 1-month good outcomes. |
• | Blood glucose levels with the best outcomes likely ranged from 200 to 250 mg/dL based on the cubic spline regression model. |
Keywords : Mortality, Survival, Cardiac arrest, Stress hyperglycemia, Neurological outcome, Prognostic factor
Abbreviation list : OHCA, CPR, ECPR, ROSC, CPC, BGA, HbA1c
Plan
Vol 77
P. 46-52 - mars 2024 Retour au numéro
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