High HbA1c is associated with decreased 6-month survival and poor outcomes after out-of-hospital cardiac arrest: a retro
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ORIGINAL RESEARCH
Open Access
High HbA1c is associated with decreased 6month survival and poor outcomes after out-of-hospital cardiac arrest: a retrospective cohort study Junhaeng Lee1, Joo Suk Oh1* , Jong Ho Zhu2, Sungyoup Hong3, Sang Hyun Park4, Ji Hoon Kim5, Hyungsoo Kim1, Mingu Seo1, Kiwook Kim1, Doo Hyo Lee1, Hyun Ho Jung1, Jungtaek Park1, Young Min Oh1, Semin Choi1 and Kyoung Ho Choi1
Abstract 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.
* Correspondence: [email protected] 1 Department of Emergency Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Republic of Korea Full list of author information is available at the end of the article
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