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Association between stress hyperglycemia on admission and unfavorable neurological outcome in OHCA patients receiving ECPR

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Clinical Research in Cardiology Aims and scope Submit manuscript

A Letter to the Editors to this article was published on 13 September 2022

A Letter to the Editors to this article was published on 13 September 2022

Abstract

Background

Stress hyperglycemia is a normal response to stress and has been associated with outcomes in out-of-hospital cardiac arrest (OHCA) patients. However, this association remained unknown in OHCA patients receiving extracorporeal cardiopulmonary resuscitation (ECPR). This study aimed to examine the association between degree of stress hyperglycemia on admission and neurological outcomes at discharge in OHCA patients receiving ECPR.

Patients and methods

This was a retrospective cohort study of adult OHCA patients receiving ECPR between 2011 and 2021. Patients were classified into three groups: absence of stress hyperglycemia (blood glucose level on admission < 200 mg/dL), moderate stress hyperglycemia (200–299 mg/dL), and severe stress hyperglycemia (≥ 300 mg/dL). The primary outcome was unfavorable neurological outcome (Cerebral Performance Category: 3–5) at discharge.

Results

This study included 160 patients; unfavorable neurological outcomes totaled 79.4% (n = 127). There were 23, 52, and 85 patients in the absence, moderate, and severe stress hyperglycemia groups, respectively. Of each group, unfavorable neurological outcomes constituted 91.3%, 71.2%, and 81.2%, respectively. Multivariable analysis showed that, compared with moderate stress hyperglycemia, absence of stress hyperglycemia on admission was significantly associated with unfavorable neurological outcome at discharge (odds ratio [OR], 4.70; 95% confidence interval [CI], 1.07–33.35; p = 0.039).

Conclusion

Compared with moderate stress hyperglycemia on admission, absence of stress hyperglycemia showed significant association with unfavorable neurological outcome at discharge in OHCA patients receiving ECPR.

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Acknowledgements

The authors acknowledge all past and present members of our hospital who participated in this study and offer special thanks to Yumi Obata, Miyuki Tada, and Moe Matsumoto at Hyogo Emergency Medical Center for their assistance in data collection.

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None.

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Author notes

  1. Takuya Taira and Akihiko Inoue contributed equally to this work.

Authors and Affiliations

  1. Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo, 651-0073, Japan

    Takuya Taira, Akihiko Inoue, Takeshi Nishimura, Ryo Takahashi, Maho Isobe, Saki Maemura, Masafumi Suga, Shinichi Ijuin, Tomoya Masano, Shigenari Matsuyama, Satoshi Ishihara & Shinichi Nakayama

  2. Faculty of Medicine, Graduate School of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita, Kagawa, 761-0793, Japan

    Takuya Taira & Yasuhiro Kuroda

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  1. Takuya Taira
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Correspondence to Akihiko Inoue.

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Taira, T., Inoue, A., Nishimura, T. et al. Association between stress hyperglycemia on admission and unfavorable neurological outcome in OHCA patients receiving ECPR. Clin Res Cardiol 112, 529–538 (2023). https://doi.org/10.1007/s00392-022-02057-4

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