Association between diabetes mellitus and poor patient outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis

Dinesh Chandra Voruganti; Adithya Chennamadhavuni; Rohan Garje; Ghanshyam Palamaner Subash Shantha; Marin L Schweizer; Saket Girotra; Michael Giudici

doi:10.1038/s41598-018-36288-1

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Association between diabetes mellitus and poor patient outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis

Journal article

Open access

Peer reviewed

Association between diabetes mellitus and poor patient outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis

Dinesh Chandra Voruganti, Adithya Chennamadhavuni, Rohan Garje, Ghanshyam Palamaner Subash Shantha, Marin L Schweizer, Saket Girotra and Michael Giudici

Scientific reports, Vol.8(1), pp.17921-8

12/18/2018

DOI: 10.1038/s41598-018-36288-1

PMCID: PMC6298970

PMID: 30560897

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Abstract

Diabetes mellitus (DM) serves as an important prognostic indicator in patients with cardiac-related illness. Our objective is to compare survival and neurological outcomes among diabetic and non-diabetic patients who were admitted to the hospital after an out-of-hospital cardiac arrest (OHCA). We searched MEDLINE and EMBASE for relevant articles from database inception to July 2018 without any language restriction. Studies were included if they evaluated patients who presented with OHCA, included mortality and neurological outcome data separately for DM patients and Non-DM patients and reported crude data, odds ratio (OR), relative risk (RR) or hazard ratio (HR). Two investigators independently reviewed the retrieved citations and assessed eligibility. The quality of included studies was evaluated using Newcastle-Ottawa quality assessment scale for cohort studies. Random-effect models using the generic variance method were used to create pooled odds ratios (OR) and 95% confidence intervals (CI). Heterogeneity was assessed using the I value. Survival and neurological outcomes (using modified rankin scale and cerebral performance category scale) after OHCA in hospitalized patients with DM compared with patients without DM. Out of 57 studies identified, six cohort studies met the inclusion criteria. In an analysis of unadjusted data, patients with DM had lower odds of survival, pooled OR 0.64; 95% CI, 0.52-0.78, [I = 90%]. When adjusted ORs were pooled, the association between DM and survival after OHCA was still significantly reduced, pooled OR 0.78, 95% CI, 0.68-0.89 [I = 55%]. Unadjusted pooled OR revealed poor neurological outcomes in patients with DM, pooled OR 0.55, 95% CI, 0.38-0.80 [I = 90%]. The result demonstrates significant poor outcomes of in-hospital survival and neurological outcomes among DM patients after OHCA.

Models, Theoretical

Out-of-Hospital Cardiac Arrest - epidemiology

Prognosis

Diabetes Mellitus - epidemiology

Humans

Survival Analysis

Out-of-Hospital Cardiac Arrest - mortality

Treatment Outcome

Hospitalization

Diabetes Mellitus - mortality

Odds Ratio

Details

Title: Subtitle: Association between diabetes mellitus and poor patient outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis
Creators: Dinesh Chandra Voruganti - Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. dinesh-voruganti@uiowa.edu
Adithya Chennamadhavuni - Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Rohan Garje - Division of Hematology and Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Ghanshyam Palamaner Subash Shantha - Division of Cardiology, University of Iowa Hospitals and Clinics, Iowa City, USA
Marin L Schweizer - University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
Saket Girotra - Division of Cardiology, University of Iowa Hospitals and Clinics, Iowa City, USA
Michael Giudici - Division of Cardiology, University of Iowa Hospitals and Clinics, Iowa City, USA
Resource Type: Journal article
Publication Details: Scientific reports, Vol.8(1), pp.17921-8
DOI: 10.1038/s41598-018-36288-1
PMID: 30560897
PMCID: PMC6298970
NLM abbreviation: Sci Rep
ISSN: 2045-2322
eISSN: 2045-2322
Grant note: K08 HL122527 / NHLBI NIH HHS
Language: English
Date published: 12/18/2018
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Cardiovascular Medicine; General Internal Medicine; Internal Medicine
Record Identifier: 9984094544602771

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