History of diabetes mellitus as a neurologic predictor in comatose survivors of cardiac arrest of cardiac origin treated with mild hypothermia.

Abstract

To investigate the impact of a history of diabetes mellitus on the neurologic outcome in comatose survivors of cardiac arrest of cardiac origin treated with mild hypothermia. A prospective observational study was performed between September 2003 and July 2008. Eighty comatose survivors of cardiac arrest of cardiac origin were treated with mild hypothermia. Neurologic outcome at the time of hospital discharge, 30-day survival, and complications were assessed. Twenty-four of the 80 patients (30%) had a history of diabetes. The rate of favorable neurologic outcome was significantly lower in diabetic (17%) than in nondiabetic patients (46%) (p=0.01). The rate of 30-day survival was lower in diabetic (33%) than in nondiabetic patients (54%), but the difference was not significant (p=0.10). Multivariate analysis suggested that a history of diabetes was an independent predictor of unfavorable neurologic outcome (odds ratio 7.00, 95% confidence interval 1.42-46.19, p=0.03), but not for 30-day survival. There was no significant difference in the prevalence of complications. A history of diabetes is associated with poor neurologic outcome in comatose survivors of cardiac arrest treated with mild hypothermia.