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Eur Heart J Acute Cardiovasc Care. 2019 Jan 11:2048872618823349. doi: 10.1177/2048872618823349. [Epub ahead of print]

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

Author information

1
1 Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark.
2
2 Emergency Medical Services Copenhagen, University of Copenhagen, Denmark.
3
3 Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Denmark.
4
4 Department of Cardiology, Hjørring Regional Hospital, Denmark.
5
5 Department of Cardiology, Aalborg University Hospital, Denmark.
6
6 The Heart Centre, Rigshospitalet, University of Copenhagen, Denmark.
7
7 Clinical Metabolic Physiology, Steno Diabetes Centre Copenhagen, University of Copenhagen, Denmark.
8
8 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
9
9 Department of Health Science and Technology, Aalborg University, Denmark.
10
10 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
11
11 The Danish Heart Foundation, Copenhagen, Denmark.

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.

KEYWORDS:

Diabetes; bystander cardiopulmonary resuscitation; out-of-hospital cardiac arrest; pre-hospital resuscitation; return of spontaneous circulation; survival

PMID:
30632777
DOI:
10.1177/2048872618823349

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