Comparison of the outcomes of targeted temperature management for the cardiac arrest patients with and without diabetes mellitus: The TIMECARD study.
Journal
Journal of the Formosan Medical Association
ISSN
0929-6646
Date Issued
2026-05-20
Author(s)
Wu, Yi-Ting
Lin, Kun Chang
Kuo, Li-Kuo
Hsu, HsinHui
Lai, Chih-Hung
Huang, Wei-Chun
Abstract
Background: Targeted temperature management (TTM) reduces mortality rates and improves neurological function in patients who experience cardiac arrest. However, the differences of outcomes in responses to TTM between cardiac arrest patients with and without diabetes mellitus (DM) require further investigation. Methods: This multicenter observational study included patients who experienced cardiac arrest and received TTM therapy between January 2013 and September 2019. Comparisons were made between DM and non-DM patient groups. Results: A total of 580 patients were enrolled. The DM group had a worse survival rate (45.3% vs. 32.0%, p = 0.0016) and worse neurological outcomes (GCS score >8: 67.5% vs. 53.2%, p = 0.0318) at hospital discharge. In the multivariate logistic regression analysis revealed that DM was a negative predictor for survival in patients who underwent cardiac arrest and were treated by TTM (OR = 1.51, 95% CI: 1.03–2.21, p = 0.0366). In the DM group, coronary intervention was a positive predictor for survival. In the non-DM group, prehospital return of spontaneous circulation was a positive predictor for survival, whereas old age >65 years and mean arterial pressure <65 mmHg were negative predictors. Conclusion: This study showed that DM is significantly associated with worse survival and neurological outcomes in patients who experience cardiac arrest and are treated by TTM. Additionally, patients with DM who had cardiogenic etiologies and initial shockable rhythms had a higher mortality rate. Some positive factors for survival, such as witness collapse and prehospital return of spontaneous circulation, were reduced in patients with DM.
Publisher
Elsevier B.V.
Type
journal article