title: Early central diabetes insipidus: An ominous sign in post-cardiac arrest patients.
abstract: OBJECTIVE
  Central diabetes insipidus (CDI) after cardiac arrest is not well described. Thus, we aim to study the occurrences, outcomes, and risk factors of CDI of survivors after out-of-hospital cardiac arrest (OHCA).
  
  
  METHODS
  We retrospectively analyzed post-OHCA patients treated at a single center. Central diabetes insipidus was retrospectively defined by diagnostic criteria. One-month cerebral performance category (CPC) scores were collected for outcomes.
  
  
  RESULTS
  Of the 169 patients evaluated, 36 patients (21.3%) were diagnosed with CDI. All CDI patients had a poor neurologic outcome of either CPC 4 (13.9%) or CPC 5 (86.1%), and CDI was strongly associated with mortality. Age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.93-0.99), respiratory arrest (OR, 6.62; 95% CI, 1.23-35.44), asphyxia (OR, 9.26; 95% CI, 2.17-34.61), and gray to white matter ratio on brain computed tomogram (OR, 0.88; 95% CI, 0.81-0.95) were associated with the development of CDI. The onset of CDI was earlier (P < .001) and the maximum 24-hour urine output was larger (P = .03) in patients with worst outcomes.
  
  
  CONCLUSIONS
  All patients diagnosed with CDI had poor neurologic outcomes, and occurrence of CDI was associated with mortality. Central diabetes insipidus patients with death or brain death had earlier occurrence of CDI and more maximum urine output.
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Minjung Kathy
authors.initials: MK
authors.lastname: Chae
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Tae Rim
authors.initials: TR
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Hee
authors.initials: H
authors.lastname: Yoon
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Sung Yeon
authors.initials: SY
authors.lastname: Hwang
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Won Chul
authors.initials: WC
authors.lastname: Cha
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Tae Gun
authors.initials: TG
authors.lastname: Shin
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea. Electronic address: coldco2@naver.com.
authors.forename: Min Seob
authors.initials: MS
authors.lastname: Sim
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Ik Joon
authors.initials: IJ
authors.lastname: Jo
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Keun Jeong
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Joong Eui
authors.initials: JE
authors.lastname: Rhee
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, Korea.
authors.forename: Yeon Kwon
authors.initials: YK
authors.lastname: Jeong
mesh_terms: D000328:Adult; D020790:Diabetes Insipidus, Neurogenic / Q000150:complications* / Q000401:mortality / Q000628:therapy; D058065:Diabetic Cardiomyopathies / Q000150:complications* / Q000401:mortality / Q000628:therapy; D003928:Diabetic Nephropathies / Q000150:complications* / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Cardiac arrest; Central diabetes insipidus; Hypernatremia; Post–cardiac arrest care; Therapeutic hypothermia