TY - JOUR
T1 - Comparison of Survival After In-Hospital Cardiac Arrest in Patients With Versus Without Diabetes Mellitus
AU - Echouffo-Tcheugui, Justin B.
AU - Kolte, Dhaval
AU - Khera, Sahil
AU - Bhatt, Deepak L.
AU - Fonarow, Gregg C.
N1 - Funding Information:
There was no specific funding for this study. Dr. Echouffo-Tcheugui is supported by the National Heart, Lung, and Blood Institute (NHLBI) grant T32 HL125232 .
Funding Information:
Dr. Fonarow reports significant consulting for Novartis, and modest consulting for Amgen, Medtronic, and Janssen; Dr. Fonarow is a member of the GWTG Steering Committee. Dr. Fonarow holds the Eliot Corday Chair of Cardiovascular Medicine at UCLA and is also supported by the Ahmanson Foundation (Los Angeles, California).
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/3/15
Y1 - 2018/3/15
N2 - Diabetes mellitus (DM) increases the risk of sudden cardiac death, but the extent to which it influences survival after an in-hospital cardiac arrest (IHCA) remains unclear. We assessed the association of DM and survival after IHCA. The study included 1,009,073 patients aged ≥18 years who underwent cardiopulmonary resuscitation for IHCA between January 2003 and December 2013, recorded in the Nationwide Inpatient Sample database. The outcomes were survival to hospital discharge and discharge disposition assessed using multivariable logistic regression accounting for relevant covariates and clustering. Of the patients with IHCA, 30.8% (310,825) had DM and were more likely to be older and to have a higher prevalence of co-morbidities including hypertension, dyslipidemia, chronic kidney disease, and previous cardiovascular disease (all p <0.001). The rates of survival to hospital discharge after IHCA were 27.0% and 25.1% in patients with and without DM, respectively. After multivariable adjustment, DM was associated with a modestly lower risk-adjusted survival to hospital discharge (adjusted OR [aOR] 0.96, 95% confidence interval [95% CI] 0.95 to 0.97, p <0.001). This association was influenced by a number of factors (all interaction p <0.001), including a lower risk of survival among patients with DM who were younger (aOR 0.93, 95% CI 0.92 to 0.94 among those aged <75 years), those with a primary cardiovascular diagnosis (aOR 0.88, 95% CI 0.86 to 0.89), and those with ventricular fibrillation/ventricular tachycardia as the cardiac arrest rhythm (aOR 0.88, 95% CI 0.79 to 0.82). Patients with DM had lower odds of being discharged home with self-care after surviving an IHCA (p <0.001). In conclusion, preexisting DM was associated with a modestly lower risk-adjusted chance of survival after an IHCA.
AB - Diabetes mellitus (DM) increases the risk of sudden cardiac death, but the extent to which it influences survival after an in-hospital cardiac arrest (IHCA) remains unclear. We assessed the association of DM and survival after IHCA. The study included 1,009,073 patients aged ≥18 years who underwent cardiopulmonary resuscitation for IHCA between January 2003 and December 2013, recorded in the Nationwide Inpatient Sample database. The outcomes were survival to hospital discharge and discharge disposition assessed using multivariable logistic regression accounting for relevant covariates and clustering. Of the patients with IHCA, 30.8% (310,825) had DM and were more likely to be older and to have a higher prevalence of co-morbidities including hypertension, dyslipidemia, chronic kidney disease, and previous cardiovascular disease (all p <0.001). The rates of survival to hospital discharge after IHCA were 27.0% and 25.1% in patients with and without DM, respectively. After multivariable adjustment, DM was associated with a modestly lower risk-adjusted survival to hospital discharge (adjusted OR [aOR] 0.96, 95% confidence interval [95% CI] 0.95 to 0.97, p <0.001). This association was influenced by a number of factors (all interaction p <0.001), including a lower risk of survival among patients with DM who were younger (aOR 0.93, 95% CI 0.92 to 0.94 among those aged <75 years), those with a primary cardiovascular diagnosis (aOR 0.88, 95% CI 0.86 to 0.89), and those with ventricular fibrillation/ventricular tachycardia as the cardiac arrest rhythm (aOR 0.88, 95% CI 0.79 to 0.82). Patients with DM had lower odds of being discharged home with self-care after surviving an IHCA (p <0.001). In conclusion, preexisting DM was associated with a modestly lower risk-adjusted chance of survival after an IHCA.
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U2 - 10.1016/j.amjcard.2017.12.005
DO - 10.1016/j.amjcard.2017.12.005
M3 - Article
C2 - 29370924
AN - SCOPUS:85040602459
SN - 0002-9149
VL - 121
SP - 671
EP - 677
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 6
ER -