Abstract
Aim
We attempted to examine the association between intra-arrest blood glucose (BG) level
and outcomes of in-hospital cardiac arrest (IHCA). The interaction between diabetes
mellitus (DM) and BG level as well as between dextrose administration and BG level
were investigated.
Methods
This single-centred retrospective study reviewed IHCA patients between 2006 and 2015.
Patients with measured intra-arrest BG levels were included. Multivariable logistic
regression analyses were conducted. Generalised additive models were used to identify
appropriate cut-off points for continuous variables. Interactions between independent
variables were assessed during the model-fitting process.
Results
Among the 580 included patients, 34 (5.9%) achieved neurologically intact survival.
There were 197 DM patients (34.0%). The mean intra-arrest BG level was 191.5 mg/dl,
with 57 patients (9.8%) experiencing hypoglycaemia (BG level ≤ 70 mg/dl). A total
of 165 patients (28.4%) received a dextrose injection. An intra-arrest BG level ≤ 150 mg/dl
was inversely associated with favourable neurological outcomes at hospital discharge
(odds ratio [OR]: 0.28, 95% confidence interval [CI]: 0.11–0.73; p-value = 0.01).
In analyses of interactions, non-DM × BG level ≤ 168 mg/dl was inversely associated
with favourable neurological outcomes (OR: 0.30, 95% CI: 0.11–0.80; p-value = 0.02).
There were no significant interactions between BG level and dextrose administration.
Conclusion
IHCA patients with intra-arrest BG level ≤ 150 mg/dl had worse neurological recovery.
Intra-arrest hypoglycaemia might be a marker of critical illness. Dextrose administration
was not shown to improve outcomes of IHCA patients with intra-arrest BG level ≤ 150 mg/dl,
indicating the need to develop new therapeutics other than dextrose administration
for these patients.
Keywords
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Article info
Publication history
Published online: November 28, 2019
Accepted:
November 16,
2019
Received in revised form:
October 14,
2019
Received:
August 2,
2019
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2019 Elsevier B.V. All rights reserved.
