Hyperglycaemia in comatose survivors of out-of-hospital cardiac arrest
| Autor: | F. Daniel Ramirez, Juan J Russo, Tyler E James, Christina Osborne, Benjamin Hibbert, George A. Wells, Jordan Bernick, Trevor Simard, Michel R. Le May |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Blood Glucose
Male Resuscitation medicine.medical_treatment 030204 cardiovascular system & hematology Return of spontaneous circulation Critical Care and Intensive Care Medicine Hypothermia induced Out of hospital cardiac arrest 03 medical and health sciences 0302 clinical medicine Hypothermia Induced Humans Medicine Cardiopulmonary resuscitation Coma Retrospective Studies Ontario business.industry Follow up studies 030208 emergency & critical care medicine Retrospective cohort study General Medicine Middle Aged Prognosis Cardiopulmonary Resuscitation Hyperglycemia Anesthesia Female medicine.symptom Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest Follow-Up Studies |
| Zdroj: | European Heart Journal: Acute Cardiovascular Care. 7:442-449 |
| ISSN: | 2048-8734 2048-8726 |
| DOI: | 10.1177/2048872616684685 |
| Popis: | Background: The optimal blood glucose target during the early hospitalisation of comatose survivors of out-of-hospital cardiac arrest (OHCA) has not been established. Methods: In a retrospective cohort study, we examined clinical outcomes in relation to mean blood glucose during the first 96 hours of hospital admission in comatose survivors of OHCA with an initial shockable rhythm. Mean blood glucose was assessed as a continuous (primary analysis) and categorical variable: Results: Among 122 eligible patients, death and severe neurological dysfunction occurred in 29 (24%) and 40 (33%) patients, respectively. Higher mean blood glucose levels during the first 96 hours of admission were associated with increased odds of death (odds ratio (OR): 1.50; 95% confidence interval (CI): 1.17–1.92; p = 0.001) and severe neurological dysfunction (OR: 1.42; 95% CI: 1.11–1.80; p = 0.004). The associations between mean blood glucose and the odds of death (OR: 1.35; 95% CI: 1.04–1.76; p = 0.02) and severe neurological dysfunction (OR: 1.28; 95% CI: 1.00–1.64; p = 0.05) persisted after adjusting for age, time from cardiac arrest to return of spontaneous circulation (ROSC) and vasoactive agent use. There was no interaction between age, time from cardiac arrest to ROSC or a history of diabetes mellitus and the relationship between mean blood glucose and co-primary outcomes. Conclusions: In comatose survivors of OHCA with initial shockable rhythms, higher mean blood glucose levels during the first 96 hours of admission are associated with increased rates of death and severe neurological dysfunction. |
| Databáze: | OpenAIRE |
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