Survival of patients with and without diabetes following out-of-hospital cardiac arrest: A nationwide Danish study. Issue 6 (September 2020)

• Record Type: Journal Article
• Authors: Mohr, Grímur Høgnason; Søndergaard, Kathrine B; Pallisgaard, Jannik L; Møller, Sidsel Gamborg; Wissenberg, Mads; Karlsson, Lena; Hansen, Steen Møller; Kragholm, Kristian; Køber, Lars; Lippert, Freddy; Folke, Fredrik; Vilsbøll, Tina; Torp-Pedersen, Christian; Gislason, Gunnar; Rajan, Shahzleen
• Is Part Of: European heart journal. Volume 9:Issue 6(2020)
• Page Start: 599
• Page End: 607
• Publication Date: 2020-09
• Subjects: Diabetes -- out-of-hospital cardiac arrest -- survival -- return of spontaneous circulation -- bystander cardiopulmonary resuscitation -- pre-hospital resuscitation; 616.1205
• DOI: 10.1177/2048872618823349
• Languages: English
• ISSNs: 2048-8726

Abstract

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.