Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in Sweden
Background It has been estimated that 80% of cases of out-of-hospital cardiac arrest (OHCA) are due to cardiac causes. It is well-documented that diabetes is a risk factor for conditions associated with sudden cardiac arrest. Type 1 diabetes (T1D) displays a threefold to fivefold increased risk of c...
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BMJ Publishing Group
2024-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/7/e080710.full |
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| author | Truls Råmunddal Zacharias Mandalenakis Araz Rawshani Oskar Angerås Petur Petursson Aidin Rawshani Christian Dworeck Erik Thunström Berkan Eken Antros Louca Sadek Nadhir |
| author_facet | Truls Råmunddal Zacharias Mandalenakis Araz Rawshani Oskar Angerås Petur Petursson Aidin Rawshani Christian Dworeck Erik Thunström Berkan Eken Antros Louca Sadek Nadhir |
| author_sort | Truls Råmunddal |
| collection | DOAJ |
| description | Background It has been estimated that 80% of cases of out-of-hospital cardiac arrest (OHCA) are due to cardiac causes. It is well-documented that diabetes is a risk factor for conditions associated with sudden cardiac arrest. Type 1 diabetes (T1D) displays a threefold to fivefold increased risk of cardiovascular disease and death compared with the general population.Objective This study aims to assess the characteristics and survival outcomes of individuals with and without T1D who experienced an OHCA. Design: A registry-based nationwide observational study with two cohorts, patients with T1D and patients without T1D. Setting: All emergency medical services and hospitals in Sweden were included in the study.Participants Using the Swedish Cardiopulmonary Resuscitation Registry, we enrolled 54 568 cases of OHCA where cardiopulmonary resuscitation was attempted between 2010 and 2020. Among them, 448 patients with T1D were identified using International Classification of Diseases-code: E10.Methods Survival analysis was performed using Kaplan-Meier and logistic regression. Multiple regression was adjusted for age, sex, cause of arrest, prevalence of T1D and time to cardiopulmonary resuscitation.Main outcome measures The outcomes were discharge status (alive vs dead), 30 days survival and neurological outcome at discharge.Results There were no significant differences in patients discharged alive with T1D 37.3% versus, 46% among cases without T1D. There was also no difference in neurological outcome. Kaplan-Meier curves yielded no significant difference in long-term survival. Multiple regression showed no significant association with survival after accounting for covariates, OR 0.99 (95% CI 0.96 to 1.02), p value=0.7. Baseline characteristics indicate that patients with T1D were 5 years younger at OHCA occurrence and had proportionally fewer cases of heart disease as the cause of arrest (57.6% vs 62.7%).Conclusion We conclude, with the current sample size, that there is no statistically significant difference in long-term or short-term survival between patients with and without T1D following OHCA. |
| format | Article |
| id | doaj-art-734071f285084f83bc23cfb46d38e081 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-07-01 |
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| spelling | doaj-art-734071f285084f83bc23cfb46d38e0812025-08-20T02:10:43ZengBMJ Publishing GroupBMJ Open2044-60552024-07-0114710.1136/bmjopen-2023-080710Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in SwedenTruls Råmunddal0Zacharias Mandalenakis1Araz Rawshani2Oskar Angerås3Petur Petursson4Aidin Rawshani5Christian Dworeck6Erik Thunström7Berkan Eken8Antros Louca9Sadek Nadhir10Department of Cardiology, Sahlgrenska University Hospital, Goteborg, SwedenDepartment of Cardiology, Sahlgrenska University Hospital, Goteborg, SwedenCentre for Digital Health, Område Digitalisering, Sahlgrenska University Hospital, Goteborg, SwedenDepartment of Cardiology, Sahlgrenska universitetssjukhuset, Goteborg, SwedenDepartment of Cardiology, Sahlgrenska universitetssjukhuset, Goteborg, SwedenUniversity of Gothenburg Institute of Medicine, Goteborg, SwedenDepartment of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, SwedenDepartment of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg, SwedenSahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenUniversity of Gothenburg Institute of Medicine, Goteborg, SwedenSahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenBackground It has been estimated that 80% of cases of out-of-hospital cardiac arrest (OHCA) are due to cardiac causes. It is well-documented that diabetes is a risk factor for conditions associated with sudden cardiac arrest. Type 1 diabetes (T1D) displays a threefold to fivefold increased risk of cardiovascular disease and death compared with the general population.Objective This study aims to assess the characteristics and survival outcomes of individuals with and without T1D who experienced an OHCA. Design: A registry-based nationwide observational study with two cohorts, patients with T1D and patients without T1D. Setting: All emergency medical services and hospitals in Sweden were included in the study.Participants Using the Swedish Cardiopulmonary Resuscitation Registry, we enrolled 54 568 cases of OHCA where cardiopulmonary resuscitation was attempted between 2010 and 2020. Among them, 448 patients with T1D were identified using International Classification of Diseases-code: E10.Methods Survival analysis was performed using Kaplan-Meier and logistic regression. Multiple regression was adjusted for age, sex, cause of arrest, prevalence of T1D and time to cardiopulmonary resuscitation.Main outcome measures The outcomes were discharge status (alive vs dead), 30 days survival and neurological outcome at discharge.Results There were no significant differences in patients discharged alive with T1D 37.3% versus, 46% among cases without T1D. There was also no difference in neurological outcome. Kaplan-Meier curves yielded no significant difference in long-term survival. Multiple regression showed no significant association with survival after accounting for covariates, OR 0.99 (95% CI 0.96 to 1.02), p value=0.7. Baseline characteristics indicate that patients with T1D were 5 years younger at OHCA occurrence and had proportionally fewer cases of heart disease as the cause of arrest (57.6% vs 62.7%).Conclusion We conclude, with the current sample size, that there is no statistically significant difference in long-term or short-term survival between patients with and without T1D following OHCA.https://bmjopen.bmj.com/content/14/7/e080710.full |
| spellingShingle | Truls Råmunddal Zacharias Mandalenakis Araz Rawshani Oskar Angerås Petur Petursson Aidin Rawshani Christian Dworeck Erik Thunström Berkan Eken Antros Louca Sadek Nadhir Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in Sweden BMJ Open |
| title | Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in Sweden |
| title_full | Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in Sweden |
| title_fullStr | Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in Sweden |
| title_full_unstemmed | Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in Sweden |
| title_short | Effects of pre-existing type 1 diabetes mellitus on survival outcome following out-of-hospital cardiac arrest: a registry-based observational study in Sweden |
| title_sort | effects of pre existing type 1 diabetes mellitus on survival outcome following out of hospital cardiac arrest a registry based observational study in sweden |
| url | https://bmjopen.bmj.com/content/14/7/e080710.full |
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