Abstract 109: Patients with Diabetes Have Decreased Survivability with Good Neurological Outcomes After Out-of-Hospital Cardiac Arrest

Abstract

Objectives: This study aims to provide a scientific evidence of the association between diabetes and the probability of OHCA survival with good neurological outcomes. Methods: Korean registry on patients survived to admission after emergency medical services (EMS)-assessed OHCA with cardiac etiology with known diabetes statuses (2009 to 2012) was used. We excluded patients without available hospital outcomes or diabetes. Diabetes was defined when the patients had history of treatment or diagnosis or positive result at laboratory test during hospital stay. Outcomes were survival to discharge with good brain recovery measured by medical record review by medical record review experts using cerebral performance category 1 or 2. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a multivariate logistic regression model adjusting for individual, Utstein, post-resuscitation factors, and comorbidities. Interaction model between diabetes and gender and heart disease were also analyzed. Results: Total 7463 patients including diabetes 1,952 (26.2%), non-diabetes 4,129 (55.3%), and unknown diabetes 1,382 (18.5%) were finally analyzed. Survival to discharge with good brain recovery was 17.7% in non-diabetes, 9.7% in diabetes 16.2% in unknown-diabetes, respectively (p<0.001). Crude OR (95% CI) was 0.50 (0.42-0.59) in diabetes and 0.89 (0.76-1.05) in unknown-diabetes comparing with non-diabetes. Adjusted OR (95% CI) was 0.78 (0.61-0.98) in diabetes and 1.07 (0.75-1.53) in unknown-diabetes comparing with non-diabetes. The adjusted OR measuring the effect of diabetes on survival with good neurological outcomes for male with history of heart disease was 0.32 (0.22-0.48, p-value <0.0001), for male without history of heart disease was 0.55 (0.34-0.89, p-value <0.0001), for female with history of heart disease was 0.60 (0.48-0.76, p-value 0.0152), and for female without history of heart disease was 1.03 (0.71-1.47, p-value 0.8919). Conclusion: This study provides evidence of significant associations of diabetes and decreased OHCA survivability with good neurological outcomes where the association is greater in male and patients with heart disease.