Abstract 263: Hyperglycemia: A Poor Prognostic Factor for Neurological Recovery in Patients with Sudden Cardiac Arrest
Background: Hyperglycemia is an independent predictor of mortality in several but not all critically ill populations. Animal cardiac arrest models suggest that hyperglycemia results in poor outcomes. We examined the effects of hyperglycemia in cardiac arrest survivors, focusing on its effects on neurological function.
Methods: We evaluated 123 survivors of non-traumatic out-of-hospital cardiac arrest .Data were collected following the Utstein guidelines. Hyperglycemia was defined as any value > 180 mg/dl. Patients who had hyperglycemia were treated with intravenous / subcutaneous insulin at the discretion of the health care team. Neurological status was assessed by Cerebral Performance Category (CPC) scores. Fisher's exact two-tailed test, univariate and multivariate logistic regression were used for analyses. Data are reported as percentage, mean + SD.
Results: Of 123 patients studied, 31% had a history of diabetes; however 72 % (88/123) were hyperglycemic. As noted below, those with hyperglycemia had similar characteristics as compared to those with normoglycemia including a history of diabetes. Hyperglycemia was more common in patients treated with hypothermia as compared to those not cooled: 83% (44/53) vs. 64 %( 44/71) respectively (P= 0.01). Poor neurological recovery (CPC > 2) was also seen more often in those with hyperglycemia as compared to those without hyperglycemia (87% vs. 68%) respectively (P= 0.01). Although univariate analysis identified hyperglycemia to be a predictor of poor neurological recovery, it did not worsen neurological recovery in hypothermia treated patients (pNS). Multivariate regression analyses, failed to identify hyperglycemia as a predictor of poor neurological outcome.
Conclusion: Hyperglycemia (>180 mg/dl) is extremely common post arrest and is implicated in poor neurological recovery. The early identification and treatment of hyperglycemia is likely justified. Patient Characteristics
- © 2011 by American Heart Association, Inc.