title: Association of blood glucose at admission with outcomes in patients treated with therapeutic hypothermia after cardiac arrest.
abstract: BACKGROUND
  It is well known that hyperglycemia is associated with poor outcomes in critically ill patients. We investigated the association between blood glucose level at admission and the outcomes of patients treated with therapeutic hypothermia (TH) after cardiac arrest.
  
  
  METHODS
  A total of 883 cardiac arrest patients who were treated with TH were analyzed from the Korean Hypothermia Network retrospective registry. We examined the association of blood glucose at admission with survival and neurologic outcomes at hospital discharge. Favorable neurologic outcomes were defined as Cerebral Performance Category scores of 1 and 2.
  
  
  RESULTS
  The mean age of the sample was 56.7 ± 16.2 years, 69.5% of subjects were male, and the mean blood glucose at admission was 14.1 ± 7.0 mmol/L. After adjustment for sex, age, history of diabetes mellitus, hypertension, renal disease and stroke, time from arrest to return of spontaneous circulation, initial rhythm, witness status, bystander cardiopulmonary resuscitation, cause of arrest, and cumulative dose of adrenaline, the associations between glucose and outcomes were as follows: for favorable neurologic outcomes, an odds ratio of 0.955 (95% confidence interval, 0.918-0.994); and for survival, an odds ratio of 0.974 (95% confidence interval, 0.952-0.996).
  
  
  CONCLUSIONS
  These results show that blood glucose level at admission is associated with survival and favorable neurologic outcomes at hospital discharge in patients treated with TH after cardiac arrest. Blood glucose level at admission could be a surrogate marker of ischemic insult severity during cardiac arrest. However, randomized, controlled evidence is needed to address the significance of tight glucose control during TH after cardiac arrest.
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seung Pill
authors.initials: SP
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kyu Nam
authors.initials: KN
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Myongji Hospital, Gyeonggi-do, Republic of Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chonbuk National University Hospital, Jeonju, Republic of Korea.
authors.forename: Tae O
authors.initials: TO
authors.lastname: Jeong
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: ycs1005@catholic.ac.kr.
authors.forename: Chun Song
authors.initials: CS
authors.lastname: Youn
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D007036:Hypothermia, Induced; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012042:Registries / Q000706:statistics & numerical data; D056910:Republic of Korea; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose