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



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.



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)).



DM increased the risk of OHCA, which was the highest in the non-pharmacotherapy group and decreased in magnitude with pharmacotherapy.
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
Young Sun
YS
Ro
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.|Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Sang Do
0000-0003-4953-2916
SD
Shin
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.|Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kyoung Jun
KJ
Song
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.|Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
Joo Yeong
JY
Kim
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.|Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Eui Jung
EJ
Lee
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.|Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yu Jin
YJ
Lee
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
Ki Ok
KO
Ahn
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.|Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Ki Jeong
KJ
Hong
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000628:therapy; D011159:Population Surveillance / Q000379:methods; D012042:Registries / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult