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

Grímur Høgnason Mohr, Kathrine B Søndergaard, Jannik L Pallisgaard, Sidsel Gamborg Møller, Mads Wissenberg, Lena Karlsson, Steen Møller Hansen, Kristian Kragholm, Lars Køber, Freddy Lippert, Fredrik Folke, Tina Vilsbøll, Christian Torp-Pedersen, Gunnar Gislason, Shahzleen Rajan

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal: Acute Cardiovascular Care
ISSN2048-8726
DOI
StatusE-pub ahead of print - 11 jan. 2019

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Out-of-Hospital Cardiac Arrest
Survival
Odds Ratio
Confidence Intervals
Cardiopulmonary Resuscitation
Heart Arrest
Registries
Comorbidity
Logistic Models

Citer dette

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. / Survival of patients with and without diabetes following out-of-hospital cardiac arrest : A nationwide Danish study. I: European Heart Journal: Acute Cardiovascular Care. 2019.
@article{0f1926a9038a43f39c3c591d06764926,
title = "Survival of patients with and without diabetes following out-of-hospital cardiac arrest: A nationwide Danish study",
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.",
author = "Mohr, {Gr{\'i}mur H{\o}gnason} and S{\o}ndergaard, {Kathrine B} and Pallisgaard, {Jannik L} and M{\o}ller, {Sidsel Gamborg} and Mads Wissenberg and Lena Karlsson and Hansen, {Steen M{\o}ller} and Kristian Kragholm and Lars K{\o}ber and Freddy Lippert and Fredrik Folke and Tina Vilsb{\o}ll and Christian Torp-Pedersen and Gunnar Gislason and Shahzleen Rajan",
year = "2019",
month = "1",
day = "11",
doi = "10.1177/2048872618823349",
language = "English",
journal = "European Heart Journal: Acute Cardiovascular Care",
issn = "2048-8726",
publisher = "SAGE Publications",

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

I: European Heart Journal: Acute Cardiovascular Care, 11.01.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Survival of patients with and without diabetes following out-of-hospital cardiac arrest

T2 - A nationwide Danish study

AU - Mohr, Grímur Høgnason

AU - Søndergaard, Kathrine B

AU - Pallisgaard, Jannik L

AU - Møller, Sidsel Gamborg

AU - Wissenberg, Mads

AU - Karlsson, Lena

AU - Hansen, Steen Møller

AU - Kragholm, Kristian

AU - Køber, Lars

AU - Lippert, Freddy

AU - Folke, Fredrik

AU - Vilsbøll, Tina

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar

AU - Rajan, Shahzleen

PY - 2019/1/11

Y1 - 2019/1/11

N2 - 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.

AB - 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.

U2 - 10.1177/2048872618823349

DO - 10.1177/2048872618823349

M3 - Journal article

JO - European Heart Journal: Acute Cardiovascular Care

JF - European Heart Journal: Acute Cardiovascular Care

SN - 2048-8726

ER -