title: The administration of dextrose during in-hospital cardiac arrest is associated with increased mortality and neurologic morbidity.
abstract: BACKGROUND
  Dextrose may be used during cardiac arrest resuscitation to prevent or reverse hypoglycemia. However, the incidence of dextrose administration during cardiac arrest and the association of dextrose administration with survival and other outcomes are unknown.
  
  
  METHODS
  We used the Get With The Guidelines®-Resuscitation national registry to identify adult patients with an in-hospital cardiac arrest between the years 2000 and 2010. To assess the adjusted effects of dextrose administration on survival, we used multivariable regression models with adjustment for multiple patient, event, and hospital characteristics. We performed additional analyses to examine the effects of dextrose on neurological outcome and return of spontaneous circulation.
  
  
  RESULTS
  Among the 100,029 patients included in our study, 4,189 (4.2%) received dextrose during cardiac arrest resuscitation. The rate of dextrose administration increased during the study period (odds ratio 1.11, 95% confidence interval (CI) 1.09-1.12 per year, P <0.001). Patients who received dextrose during resuscitation had lower rates of survival compared with patients who did not receive dextrose (relative risk 0.88, 95% CI 0.80-0.98, P = 0.02). Administration of dextrose was associated with worse neurological outcome (relative risk 0.88, 95% CI 0.79-0.99, P = 0.03) but an increased chance of return of spontaneous circulation (relative risk 1.07, 95% CI 1.04-1.10, P <0.001).
  
  
  CONCLUSIONS
  In this dataset, the administration of dextrose during resuscitation in patients with in-hospital cardiac arrest was found to be associated with a significantly decreased chance of survival and a decreased chance of good neurological outcome.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. teng@bu.edu.
authors.forename: Teng J
authors.initials: TJ
authors.lastname: Peng
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. lwanders@bidmc.harvard.edu.|Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark. lwanders@bidmc.harvard.edu.
authors.forename: Lars W
authors.initials: LW
authors.lastname: Andersen
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. bsaindon@bu.edu.
authors.forename: Brian Z
authors.initials: BZ
authors.lastname: Saindon
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. tyler.a.giberson.med@dartmouth.edu.
authors.forename: Tyler A
authors.initials: TA
authors.lastname: Giberson
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. wonpia@yahoo.co.kr.
authors.forename: Won Young
authors.initials: WY
authors.lastname: Kim
authors.affiliation: Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. kberg@bidmc.harvard.edu.
authors.forename: Katherine
authors.initials: K
authors.lastname: Berg
authors.affiliation: Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. victorno@clalit.org.il.|Clinical Research Center, Soroka University Medical Centers, Beer-Shave, Israel. victorno@clalit.org.il.
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. mdonnino@bidmc.harvard.edu.|Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. mdonnino@bidmc.harvard.edu.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Donnino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000401:mortality; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000009:adverse effects*; D006323:Heart Arrest / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012042:Registries
chemical_list: D005947:Glucose