Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Division of Hematology and Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Sci Rep. 2018 Dec 18;8(1):17921. doi: 10.1038/s41598-018-36288-1.
Diabetes mellitus (DM) serves as an important prognostic indicator in patients with cardiac-related illness. Our objective is to compare survival and neurological outcomes among diabetic and non-diabetic patients who were admitted to the hospital after an out-of-hospital cardiac arrest (OHCA). We searched MEDLINE and EMBASE for relevant articles from database inception to July 2018 without any language restriction. Studies were included if they evaluated patients who presented with OHCA, included mortality and neurological outcome data separately for DM patients and Non-DM patients and reported crude data, odds ratio (OR), relative risk (RR) or hazard ratio (HR). Two investigators independently reviewed the retrieved citations and assessed eligibility. The quality of included studies was evaluated using Newcastle-Ottawa quality assessment scale for cohort studies. Random-effect models using the generic variance method were used to create pooled odds ratios (OR) and 95% confidence intervals (CI). Heterogeneity was assessed using the I value. Survival and neurological outcomes (using modified rankin scale and cerebral performance category scale) after OHCA in hospitalized patients with DM compared with patients without DM. Out of 57 studies identified, six cohort studies met the inclusion criteria. In an analysis of unadjusted data, patients with DM had lower odds of survival, pooled OR 0.64; 95% CI, 0.52-0.78, [I = 90%]. When adjusted ORs were pooled, the association between DM and survival after OHCA was still significantly reduced, pooled OR 0.78, 95% CI, 0.68-0.89 [I = 55%]. Unadjusted pooled OR revealed poor neurological outcomes in patients with DM, pooled OR 0.55, 95% CI, 0.38-0.80 [I = 90%]. The result demonstrates significant poor outcomes of in-hospital survival and neurological outcomes among DM patients after OHCA.
糖尿病（DM）是与心脏相关疾病患者的重要预后指标。我们的目的是比较患有院外心脏骤停（OHCA）后住院的糖尿病和非糖尿病患者的生存和神经结局。我们在 MEDLINE 和 EMBASE 中进行了检索，检索范围从数据库建立到 2018 年 7 月，没有任何语言限制。如果研究评估了患有 OHCA 的患者，分别为 DM 患者和非 DM 患者报告死亡率和神经结局数据，并报告了原始数据、比值比（OR）、相对风险（RR）或风险比（HR），则将其纳入研究。两名研究者独立审查了检索到的引文并评估了纳入标准。使用纽卡斯尔-渥太华质量评估量表对队列研究进行了纳入研究的质量评估。使用通用方差法的随机效应模型用于创建汇总比值比（OR）和 95%置信区间（CI）。使用 I 值评估异质性。与无糖尿病的患者相比，患有糖尿病的 OHCA 住院患者的生存和神经结局（使用改良的 Rankin 量表和脑性能分类量表）。在确定的 57 项研究中，有 6 项队列研究符合纳入标准。在对未调整数据的分析中，患有 DM 的患者的生存率较低，汇总 OR 为 0.64；95%CI，0.52-0.78，[I=90%]。当汇总调整后的 OR 时，DM 与 OHCA 后生存之间的关联仍然显著降低，汇总 OR 为 0.78，95%CI，0.68-0.89 [I=55%]。未调整的汇总 OR 显示 DM 患者的神经结局较差，汇总 OR 为 0.55，95%CI，0.38-0.80 [I=90%]。结果表明，DM 患者在 OHCA 后住院的生存和神经结局较差。
