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Higher Prehospital Blood Glucose Levels Associated With Return of Spontaneous Circulation in Out-of-Hospital Non-traumatic Cardiac Arrests.
Shehadeh, Ayman; Feng, Jeffrey; Selde, William; Billian, Joseph; Mastenbrook, Joshua.
Afiliação
  • Shehadeh A; Department of Student Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.
  • Feng J; Department of Student Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.
  • Selde W; Department of Emergency Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.
  • Billian J; Department of Biomedical Informatics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.
  • Mastenbrook J; Department of Emergency Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI. Electronic address: Joshua.Mastenbrook@wmed.edu.
Air Med J ; 42(6): 471-476, 2023.
Article em En | MEDLINE | ID: mdl-37996185
OBJECTIVE: Cardiac arrest leads to an array of metabolic disturbances. We aimed to investigate the association between prehospital blood glucose levels (BGLs) and rates of return of spontaneous circulation (ROSC) in non-traumatic out-of-hospital cardiac arrests (OHCAs). METHODS: A retrospective analysis of adult non-traumatic OHCAs within Kalamazoo County, MI, from January 2018 to May 2020 using the Michigan Emergency Medical Services Information System database was performed. Demographic data, Utstein variables, and BGLs (hypoglycemia < 70 mg/dL, euglycemia 70-120 mg/dL, and hyperglycemia >120 mg/dL) were abstracted. Chi-square and Wilcoxon rank sum tests were used to evaluate the relationship between BGL and ROSC. RESULTS: In total, 314 patients met the inclusion criteria. The mean age was 62.9 years. ROSC was achieved in 147 (46.8%) patients. Fifty (15.9%), 75 (23.9%), and 189 (60.2%) patients were hypoglycemic, euglycemic, and hyperglycemic, respectively. An association was found between the glycemic group and ROSC (P < .0001), with an estimated odds of ROSC being 77% lower (95% confidence interval, 46%-90%) for hypoglycemic than euglycemic or hyperglycemic patients. The point difference between median ROSC-yes BGL (median [interquartile range] = 160 mg/dL [110-225 mg/dL]) was 33 mg/dL (95% CI, 13-51 mg/dL) greater than the ROSC-no group (median [interquartile range] = 127 mg/dL [75-190 mg/dL], P = .001). CONCLUSION: Non-traumatic OHCA patients achieving ROSC had a significantly higher prehospital BGL than the ROSC-no group. Further study is warranted to investigate the role intra-arrest BGL may have as a prognostic marker for ROSC.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Reanimação Cardiopulmonar / Serviços Médicos de Emergência / Parada Cardíaca Extra-Hospitalar Limite: Adult / Humans / Middle aged Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Reanimação Cardiopulmonar / Serviços Médicos de Emergência / Parada Cardíaca Extra-Hospitalar Limite: Adult / Humans / Middle aged Idioma: En Ano de publicação: 2023 Tipo de documento: Article