scholarly journals High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Junhaeng Lee ◽  
Joo Suk Oh ◽  
Jong Ho Zhu ◽  
Sungyoup Hong ◽  
Sang Hyun Park ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
High Hba1c ◽  
Poor Outcomes ◽  
Hospital Cardiac Arrest

scholarly journals High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study

2020 ◽  
Author(s):  
Junhaeng Lee ◽  
Joo Suk Oh ◽  
Jong Ho Zuh ◽  
Sungyoup Hong ◽  
Sang Hyun Park ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Prognostic Significance ◽  
Temperature Management ◽  
Secondary Outcome ◽  
High Hba1c ◽  
Poor Outcomes ◽  
Hospital Cardiac Arrest

Abstract Background: To evaluate the associations between glycated hemoglobin (HbA1c) at admission and 6-month mortality and outcomes after out-of-hospital cardiac arrest (OHCA) treated by hypothermic targeted temperature management (TTM).Methods: This single-center retrospective cohort study included adult OHCA survivors who underwent hypothermic TTM from December 2011 to December 2019. High HbA1c at admission was defined as a level higher than 6%. Poor neurological outcomes were defined as cerebral performance category scores of 3-5. The primary outcome was 6-month mortality. The secondary outcome was the 6-month neurological outcome. Descriptive statistics, log-rank tests, and multivariable regression modeling were used for data analysis.Results: Of the 302 patients included in the final analysis, 102 patients (33.8%) had HbA1c levels higher than 6%. The high HbA1c group had significantly worse 6-month survival (12.7% vs. 37.5%, p < 0.001) and 6-month outcomes (89.2% vs. 73.0%, p = 0.001) than the non-high HbA1c group. Kaplan-Meier analysis and the log-rank test showed that the survival time was significantly shorter in the patients with HbA1c >6% than in those with HbA1c ≤6%. In the multivariable logistic regression analysis, HbA1c >6% was independently associated with 6-month mortality (OR 5.85, 95% CI 2.26-15.12, p < 0.001) and poor outcomes (OR 4.18, 95% CI 1.41-12.40, p < 0.001).Conclusions: This study showed that HbA1c higher than 6% at admission was associated with increased 6-month mortality and poor outcomes in OHCA survivors treated with hypothermic TTM. Poor long-term glycemic management may have prognostic significance after cardiac arrest.

scholarly journals High Hba1c is Associated With Decreased 6-month Survival and Poor Outcomes After Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Junhaeng Lee ◽  
Joo Suk Oh ◽  
Jong Ho Zuh ◽  
Sungyoup Hong ◽  
Sang Hyun Park ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Prognostic Significance ◽  
Cerebral Performance Category ◽  
Temperature Management ◽  
Secondary Outcome ◽  
High Hba1c ◽  
Poor Outcomes

Abstract Background: To evaluate the associations between glycated hemoglobin (HbA1c) at admission and 6-month mortality and outcomes after out-of-cardiac arrest (OHCA) treated by hypothermic targeted temperature management (TTM).Methods: This single-center retrospective cohort study included adult OHCA survivors who underwent hypothermic TTM from December 2011 to December 2019. High HbA1c at admission was defined as a level higher than 6%. Poor neurological outcomes were defined as cerebral performance category scores of 3-5. The primary outcome was 6-month mortality. The secondary outcome was the 6-month neurological outcome. Descriptive statistics, log-rank tests, and multivariable regression modelling were used for data analysis.Results: Of the 302 patients included in the final analysis, 102 patients (33.8%) had HbA1c levels higher than 6%. The high HbA1c group had significantly worse 6-month survival (12.7% vs. 37.5%, p < 0.001) and 6-month outcomes (89.2% vs. 73.0%, p = 0.001) compared to the non-high HbA1c group. Kaplan-Meier analysis and the log-rank test showed that the survival time was significantly shorter in the patients with HbA1c >6% than in those with HbA1c ≤6%. In the multivariable logistic regression analysis, HbA1c >6% was independently associated with 6-month mortality (OR 5.85, 95% CI 2.26-15.12, p < 0.001) and poor outcomes (OR 4.18, 95% CI 1.41-12.40, p < 0.001).Conclusions: This study showed that HbA1c higher than 6% at admission was associated with increased 6-month mortality and poor outcomes in OHCA survivors treated with hypothermic TTM. Poor long-term glycemic management may have prognostic significance after cardiac arrest.

Impact of rapid response car system on ECMO in out-of-hospital cardiac arrest: A retrospective cohort study

2018 ◽  
Vol 36 (3) ◽  
pp. 442-445 ◽  
Author(s):  
Ryota Sato ◽  
Akira Kuriyama ◽  
Michitaka Nasu ◽  
Shinnji Gima ◽  
Wataru Iwanaga ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Rapid Response ◽  
Hospital Cardiac Arrest

Dispatcher Identification of Out-of-Hospital Cardiac Arrest and Neurologically Intact Survival: A Retrospective Cohort Study

2019 ◽  
Vol 35 (1) ◽  
pp. 17-23
Author(s):  
Julian G. Mapp ◽  
Anthony M. Darrington ◽  
Stephen A. Harper ◽  
Chetan U. Kharod ◽  
David A. Miramontes ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cohort Study ◽  
Hospital Discharge ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
San Antonio ◽  
Cerebral Performance Category ◽  
Published Data ◽  
Neurologically Intact ◽  
Hospital Cardiac Arrest

AbstractIntroduction:To date, there are no published data on the association of patient-centered outcomes and accurate public-safety answering point (PSAP) dispatch in an American population. The goal of this study is to determine if PSAP dispatcher recognition of out-of-hospital cardiac arrest (OHCA) is associated with neurologically intact survival to hospital discharge.Methods:This retrospective cohort study is an analysis of prospectively collected Quality Assurance/Quality Improvement (QA/QI) data from the San Antonio Fire Department (SAFD; San Antonio, Texas USA) OHCA registry from January 2013 through December 2015. Exclusion criteria were: Emergency Medical Services (EMS)-witnessed arrest, traumatic arrest, age <18 years old, no dispatch type recorded, and missing outcome data. The primary exposure was dispatcher recognition of cardiac arrest. The primary outcome was neurologically intact survival (defined as Cerebral Performance Category [CPC] 1 or 2) to hospital discharge. The secondary outcomes were: bystander cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and prehospital return of spontaneous return of circulation (ROSC).Results:Of 3,469 consecutive OHCA cases, 2,569 cases were included in this analysis. The PSAP dispatched 1,964/2,569 (76.4%) of confirmed OHCA cases correctly. The PSAP dispatched 605/2,569 (23.6%) of confirmed OHCA cases as another chief complaint. Neurologically intact survival to hospital discharge occurred in 99/1,964 (5.0%) of the recognized cardiac arrest group and 28/605 (4.6%) of the unrecognized cardiac arrest group (OR = 1.09; 95% CI, 0.71–1.70). Bystander CPR occurred in 975/1,964 (49.6%) of the recognized cardiac arrest group versus 138/605 (22.8%) of the unrecognized cardiac arrest group (OR = 3.34; 95% CI, 2.70–4.11).Conclusion:This study found no association between PSAP dispatcher identification of OHCA and neurologically intact survival to hospital discharge. Dispatcher identification of OHCA remains an important, but not singularly decisive link in the OHCA chain of survival.

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