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Original research
High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study
Joo Suk Oh
Catholic University of Korea School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0519-9824
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.
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.
Keywords
hemoglobin, hypothermic, cohort, neurological
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CURRENT STATUS: Published
Version 2
Posted 20 Aug, 2020
Published
On 03 Sep, 2020
No community comments so far
Editorial decision: Accept
On 26 Aug, 2020
Editor assigned
On 17 Aug, 2020
Submission checks complete
On 16 Aug, 2020
Editor invited
On 16 Aug, 2020
No comments provided
Editorial decision: Minor Revision
On 30 Jul, 2020
Review #2 received
Received 17 Jul, 2020
Review #3 received
Received 17 Jul, 2020
Reviewers invited
Invitations sent on 08 Jul, 2020
Reviewer #1 agreed
On 08 Jul, 2020
Reviewer #2 agreed
On 08 Jul, 2020
Reviewer #3 agreed
On 08 Jul, 2020
Reviewer #4 agreed
On 08 Jul, 2020
Review #1 received
Received 08 Jul, 2020
Editor assigned
On 24 Jun, 2020
Submission checks complete
On 23 Jun, 2020
Editor invited
On 23 Jun, 2020
First submitted
On 18 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Original research
High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study
Joo Suk Oh
Catholic University of Korea School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0519-9824
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 20 Aug, 2020
Published
On 03 Sep, 2020
No community comments so far
Editorial decision: Accept
On 26 Aug, 2020
Editor assigned
On 17 Aug, 2020
Submission checks complete
On 16 Aug, 2020
Editor invited
On 16 Aug, 2020
No comments provided
Editorial decision: Minor Revision
On 30 Jul, 2020
Review #2 received
Received 17 Jul, 2020
Review #3 received
Received 17 Jul, 2020
Reviewers invited
Invitations sent on 08 Jul, 2020
Reviewer #1 agreed
On 08 Jul, 2020
Reviewer #2 agreed
On 08 Jul, 2020
Reviewer #3 agreed
On 08 Jul, 2020
Reviewer #4 agreed
On 08 Jul, 2020
Review #1 received
Received 08 Jul, 2020
Editor assigned
On 24 Jun, 2020
Submission checks complete
On 23 Jun, 2020
Editor invited
On 23 Jun, 2020
First submitted
On 18 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.
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.
Figure 1
Figure 2
Figure 3