Risk of Diabetes Mellitus on Incidence of Out-of-Hospital Cardiac Arrests: A Case-Control Study.

Abstract

BACKGROUND: This study aimed to determine the risk of diabetes mellitus (DM) on incidence of out-of-hospital cardiac arrest (OHCA) and to investigate whether difference in effects of DM between therapeutic methods was observed. METHODS: This study was a case-control study using the Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance (CAPTURES) project database and 2013 Korean Community Health Survey (CHS). Cases were defined as EMS-treated adult (18 year old and older) OHCA patients with presumed cardiac etiology collected at 27 emergency departments from January to December 2014. OHCA patients whose arrest occurred at nursing homes or clinics and cases with unknown information on DM were excluded. Four controls were matched to one case with strata including age, gender, and county from the Korean CHS database. Multivariable conditional logistic regression analysis was conducted to estimate the risk of DM and treatment modality on incidence of OHCA. RESULTS: Total 1,386 OHCA patients and 5,544 community-based controls were analyzed. A total of 370 (26.7%) among cases and 860 (15.5%) among controls were diagnosed with DM. DM was associated with increasing risk of OHCA (AOR: 1.92 (1.65-2.24)). By DM treatment modality comparing with non-DM group, AOR (95% CI) was the highest in non-pharmacotherapy only group (4.65 (2.00-10.84)), followed by no treatment group (4.17 (2.91-5.96)), insulin group (2.69 (1.82-3.96)), and oral hypoglycemic agent group (1.55 (1.31-1.85)). CONCLUSION: DM increased the risk of OHCA, which was the highest in the non-pharmacotherapy group and decreased in magnitude with pharmacotherapy.