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首页> 外文期刊>The American Journal of Cardiology >Comparison of Survival After In-Hospital Cardiac Arrest in Patients With Versus Without Diabetes Mellitus
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Comparison of Survival After In-Hospital Cardiac Arrest in Patients With Versus Without Diabetes Mellitus

机译：与糖尿病患者患者在医院心脏骤停后存活率的比较

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Diabetes mellitus (DM) increases the risk of sudden cardiac death, but the extent to which it influences survival after an in-hospital cardiac arrest (IHCA) remains unclear. We assessed the association of DM and survival after IHCA. The study included 1,009,073 patients aged = 1.8 years who underwent cardiopulmonary resuscitation for IHCA between January 2003 and December 2013, recorded in the Nationwide Inpatient Sample database. The outcomes were survival to hospital discharge and discharge disposition assessed using multivariable logistic regression accounting for relevant covariates and clustering. Of the patients with IHCA, 30.8% (310,825) had DM and were more likely to be older and to have a higher prevalence of co-morbidities including hypertension, dyslipidemia, chronic kidney disease, and previous cardiovascular disease (all p 0.001). The rates of survival to hospital discharge after IHCA were 27.0% and 25.1% in patients with and without DM, respectively. After multivariable adjustment, DM was associated with a modestly lower risk-adjusted survival to hospital discharge (adjusted OR [aOR] 0.96, 95% confidence interval [95% CI] 0.95 to 0.97, p 0.001). This association was influenced by a number of factors (all interaction p 0.001), including a lower risk of survival among patients with DM who were younger (aOR 0.93, 95% CI 0.92 to 0.94 among those aged 75 years), those with a primary cardiovascular diagnosis (aOR 0.88, 95% CI 0.86 to 0.89), and those with ventricular fibrillation/ventricular tachycardia as the cardiac arrest rhythm (aOR 0.88, 95% CI 0.79 to 0.82). Patients with DM had lower odds of being discharged home with self-care after surviving an IHCA (p 0.001). In conclusion, preexisting DM was associated with a modestly lower risk adjusted chance of survival after an IHCA. (C) 2017 Elsevier Inc. All rights reserved.
机译：糖尿病（DM）增加了心脏死亡突然死亡的风险，但在医院内心脏骤停（IHCA）后它会影响生存的程度尚不清楚。我们评估了IHCA后DM和生存的关联。该研究包括1,009,073名患者，≥1.8岁，在2003年1月至2013年12月之间接受了IHCA的心肺复苏，记录在全国住院性样本数据库中。结果是使用多变量逻辑回归核算的医院放电和放电处理的生存，以获得相关的协变量和聚类。 IHCA患者，30.8％（310,825）的DM，更容易成长，并且具有高血压，血脂血症，慢性肾脏疾病和以前的心血管疾病（所有P <0.001）具有更高的持续生命性患病率。在IHCA后，医院放电的存活率分别为17.0％和25.1％，分别为14.0％和25.1％。多变量调节后，DM与适度降低的风险调节的存活率与医院放电（调节或[AOR] 0.96,95％置信区间[95％CI] 0.95至0.97，P <0.001）相关。该关联受到许多因素的影响（所有相互作用P＆ 0.001），包括患者患者的患者的生存风险较小（AOR 0.93,95％CI 0.92至0.94，在75岁之间为0.92至0.94），具有主要心血管诊断的那些（AOR 0.88,95％CI 0.86至0.89），以及具有心室颤动/心室性心动过速的人，如心脏骤停节律（AOR 0.88,95％CI 0.79至0.82）。患有DM的患者在存活后，在IHCA（P <0.001）后，自我保健有可能较低。总之，预先存在的DM与IHCA后的较低风险调整后的存活机会有关。 （c）2017年Elsevier Inc.保留所有权利。

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