Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark.
Emergency Medical Services Copenhagen, University of Copenhagen, Denmark.
Eur Heart J Acute Cardiovasc Care. 2020 Sep;9(6):599-607. doi: 10.1177/2048872618823349. Epub 2019 Jan 11.
Research regarding out-of-hospital cardiac arrest (OHCA) survival of diabetes patients is sparse and it remains unknown whether initiatives to increase OHCA survival benefit diabetes and non-diabetes patients equally. We therefore examined overall and temporal survival in diabetes and non-diabetes patients following OHCA.
Adult presumed cardiac-caused OHCAs were identified from the Danish Cardiac Arrest Registry (2001-2014). Associations between diabetes and return of spontaneous circulation upon hospital arrival and 30-day survival were estimated with logistic regression adjusted for patient- and OHCA-related characteristics.
In total, 28,955 OHCAs were included of which 4276 (14.8%) had diabetes. Compared with non-diabetes patients, diabetes patients had more comorbidities, same prevalence of bystander-witnessed arrests (51.7% vs. 52.7%) and bystander cardiopulmonary resuscitation (43.2% vs. 42.0%), more arrests in residential locations (77.3% vs. 73.0%) and were less likely to have shockable heart rhythm (23.5% vs. 27.9%). Temporal increases in return of spontaneous circulation and 30-day survival were seen for both groups (return of spontaneous circulation: 8.8% in 2001 to 22.3% in 2014 (diabetes patients) vs. 7.8% in 2001 to 25.7% in 2014 (non-diabetes patients); and 30-day survival: 2.8% in 2001 to 9.7% in 2014 vs. 3.5% to 14.8% in 2014, respectively). In adjusted models, diabetes was associated with decreased odds of return of spontaneous circulation (odds ratio 0.74 (95% confidence interval 0.66-0.82)) and 30-day survival (odds ratio 0.56 (95% confidence interval 0.48-0.65)) (interaction with calendar year =0.434 and =0.243, respectively).
No significant difference in temporal survival was found between the two groups. However, diabetes was associated with lower odds of return of spontaneous circulation and 30-day survival.
关于院外心脏骤停（OHCA）中糖尿病患者的生存研究较少，目前尚不清楚增加 OHCA 生存率是否同样有益于糖尿病和非糖尿病患者。因此，我们研究了 OHCA 后糖尿病和非糖尿病患者的总体和时间生存情况。
从丹麦心脏骤停登记处（2001-2014 年）中确定成人疑似心源性 OHCA。使用逻辑回归调整患者和 OHCA 相关特征后，估计糖尿病与入院时自主循环恢复和 30 天生存率之间的关系。
共纳入 28955 例 OHCA，其中 4276 例（14.8%）患有糖尿病。与非糖尿病患者相比，糖尿病患者合并症更多，旁观者目击的发生率相同（51.7% vs. 52.7%）和旁观者心肺复苏（43.2% vs. 42.0%），更多的停搏发生在住宅地点（77.3% vs. 73.0%），且更有可能无可电击心律（23.5% vs. 27.9%）。两组患者的自主循环恢复和 30 天生存率均呈时间性增加（自主循环恢复：糖尿病患者 2001 年为 8.8%，2014 年为 22.3%（非糖尿病患者），2001 年为 7.8%，2014 年为 25.7%；30 天生存率：2001 年为 2.8%，2014 年为 9.7%，2014 年为 3.5%至 14.8%）。在调整后的模型中，糖尿病与自主循环恢复（比值比 0.74（95%置信区间 0.66-0.82））和 30 天生存率（比值比 0.56（95%置信区间 0.48-0.65））的可能性降低相关（交互作用的年日历 =0.434 和 =0.243）。
两组患者的生存时间无显著差异。然而，糖尿病与自主循环恢复和 30 天生存率降低相关。
