Effect of Metformin on Survival Outcomes in In-Hospital Cardiac Arrest Patients With Diabetes

초록

Study Objectives Metformin is associated with reduced mortality in patients with diabetes mellitus (DM). In cardiac arrest and ischemia-reperfusion injury animal models, metformin has shown cardioprotective and neuroprotective effects. Therefore, this study aimed to determine the association between metformin and survival outcomes in in-hospital cardiac arrest (IHCA) patients with type 2 DM (T2DM). Methods This retrospective observational study included adult IHCA patients with T2DM between January 2018 and December 2020. Administration of diabetes medications within 24 h before IHCA that were confirmed using electronic medical record was collected. The primary outcome was survival to discharge. Multivariable logistic regression analysis was performed. Results Of total 252 included IHCA patients, administration of metformin within 24 h before IHCA was associated with a higher rate of survival to discharge and good neurologic outcome (38.2% vs 9.6%, P < 0.001 and 20.6% vs 3.7%, P < 0.001, respectively). Administration of metformin within 24 h before IHCA was independently associated with survival to discharge and good neurologic outcome (adjusted odds ratio [aOR]: 5.64, 95% confidence interval [CI]: 1.74–18.27, P = 0.004 and aOR: 5.66, 95% CI: 1.26–25.40, P = 0.024, respectively). Conclusions Administration of metformin within 24 h before IHCA was independently associated with survival to discharge in IHCA patients with T2DM.