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.
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Posted 20 Aug, 2020
On 03 Sep, 2020
On 26 Aug, 2020
On 17 Aug, 2020
On 16 Aug, 2020
On 16 Aug, 2020
On 30 Jul, 2020
Received 17 Jul, 2020
Received 17 Jul, 2020
Invitations sent on 08 Jul, 2020
On 08 Jul, 2020
On 08 Jul, 2020
On 08 Jul, 2020
On 08 Jul, 2020
Received 08 Jul, 2020
On 24 Jun, 2020
On 23 Jun, 2020
On 23 Jun, 2020
On 18 Jun, 2020
Posted 20 Aug, 2020
On 03 Sep, 2020
On 26 Aug, 2020
On 17 Aug, 2020
On 16 Aug, 2020
On 16 Aug, 2020
On 30 Jul, 2020
Received 17 Jul, 2020
Received 17 Jul, 2020
Invitations sent on 08 Jul, 2020
On 08 Jul, 2020
On 08 Jul, 2020
On 08 Jul, 2020
On 08 Jul, 2020
Received 08 Jul, 2020
On 24 Jun, 2020
On 23 Jun, 2020
On 23 Jun, 2020
On 18 Jun, 2020
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
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