{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:46:34Z","timestamp":1760240794702,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2017R1D1A1B03034365"],"award-info":[{"award-number":["NRF-2017R1D1A1B03034365"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We investigated whether achieving estimated average glucose (EAG) levels versus achieving standard glucose levels (180 mg\/dL) was associated with neurologic outcome in cardiac arrest survivors. This single-center retrospective observational study included adult comatose cardiac arrest survivors undergoing therapeutic hypothermia (TH) from September 2011 to December 2017. EAG level was calculated using HbA1c obtained after the return of spontaneous circulation (ROSC), and the mean glucose level during TH was calculated. We designated patients to the EAG or standard glucose group according to whether the mean blood glucose level was closer to the EAG level or 180 mg\/dL. Patients in the EAG and standard groups were propensity score- matched. The primary outcome was the 6-month neurologic outcome. The secondary outcomes were hypoglycemia (\u226470 mg\/dL) and serum neuron-specific enolase (NSE) at 48 h after ROSC. Of 384 included patients, 137 (35.7%) had a favorable neurologic outcome. The EAG group had a higher favorable neurologic outcome (104\/248 versus 33\/136), higher incidence of hypoglycemia (46\/248 versus 11\/136), and lower NSE level. After propensity score matching, both groups had similar favorable neurologic outcomes (24\/93 versus 27\/93) and NSE levels; the EAG group had a higher incidence of hypoglycemia (21\/93 versus 6\/93). Achieving EAG levels was associated with hypoglycemia but not neurologic outcome or serum NSE level.<\/jats:p>","DOI":"10.3390\/jcm8091480","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T04:26:46Z","timestamp":1568780806000},"page":"1480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between Achievement of Estimated Average Glucose Level and 6-Month Neurologic Outcome in Comatose Cardiac Arrest Survivors: A Propensity Score-Matched Analysis"],"prefix":"10.3390","volume":"8","author":[{"given":"Yong Hun","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University, Chonnam National University Hospital, 160, Beakseo-ro, Dong-gu, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3571-9448","authenticated-orcid":false,"given":"Byung Kook","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University, Chonnam National University Hospital, 160, Beakseo-ro, Dong-gu, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Woon","family":"Jeung","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University, Chonnam National University Hospital, 160, Beakseo-ro, Dong-gu, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3612-3443","authenticated-orcid":false,"given":"Dong Hun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University, Chonnam National University Hospital, 160, Beakseo-ro, Dong-gu, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyoung Youn","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University, Chonnam National University Hospital, 160, Beakseo-ro, Dong-gu, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Soo","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University, Chonnam National University Hospital, 160, Beakseo-ro, Dong-gu, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6709-7703","authenticated-orcid":false,"given":"Chun Song","family":"Youn","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Soo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong II","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University, Chonnam National University Hospital, 160, Beakseo-ro, Dong-gu, Gwangju 61469, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.resuscitation.2015.07.018","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine Guidelines for Post-resuscitation Care 2015: Section 5 of the European Resuscitation Council Guidelines for Resuscitation 2015","volume":"95","author":"Nolan","year":"2015","journal-title":"Resuscitation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S465","DOI":"10.1161\/CIR.0000000000000262","article-title":"Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"132","author":"Callaway","year":"2015","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/S0300-9572(03)00238-7","article-title":"A multiple logistic regression analysis of in-hospital factors related to survival at six months in patients resuscitated from out-of-hospital ventricular fibrillation","volume":"59","author":"Skrifvars","year":"2003","journal-title":"Resuscitation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/CCM.0b013e3181fa4301","article-title":"Adverse events and their relation to mortality in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia","volume":"39","author":"Nielsen","year":"2011","journal-title":"Crit. Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/j.ajem.2014.05.004","article-title":"Association of blood glucose at admission with outcomes in patients treated with therapeutic hypothermia after cardiac arrest","volume":"32","author":"Kim","year":"2014","journal-title":"Am. J. Emerg. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S0749-0704(05)70154-8","article-title":"Stress-induced hyperglycemia","volume":"17","author":"McCowen","year":"2011","journal-title":"Crit. Care Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1056\/NEJMoa0810625","article-title":"Intensive versus conventional glucose control in critically ill patients","volume":"360","author":"Investigators","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1007\/s00134-007-0876-8","article-title":"Strict versus moderate glucose control after resuscitation from ventricular fibrillation","volume":"33","author":"Oksanen","year":"2007","journal-title":"Intensive Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1007\/s00125-007-0803-0","article-title":"Relationship between glycated haemoglobin levels and mean glucose levels over time","volume":"50","author":"Nathan","year":"2007","journal-title":"Diabetologia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S1056-8727(01)00227-6","article-title":"High and low hemoglobin glycation phenotypes in type 1 diabetes: A challenge for interpretation of glycemic control","volume":"16","author":"Hempe","year":"2002","journal-title":"J. Diabetes Complicat."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1056\/NEJM198402093100602","article-title":"The clinical information value of the glycosylated hemoglobin assay","volume":"310","author":"Nathan","year":"1984","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.2337\/dc08-0545","article-title":"Translating the A1C assay into estimated average glucose values","volume":"31","author":"Nathan","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.resuscitation.2018.09.017","article-title":"The association between long-term glycaemic control, glycaemic gap and neurological outcome of in-hospital cardiac arrest in diabetics: A retrospective cohort study","volume":"133","author":"Wang","year":"2018","journal-title":"Resuscitation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1097\/00003246-199811000-00016","article-title":"Use of the SOFA score to assess the incidence of organ dysfunction\/failure in intensive care units: Results of a multicenter, prospective study. Working group on \"sepsis-related problems\" of the European Society of Intensive Care Medicine","volume":"26","author":"Vincent","year":"1998","journal-title":"Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2010). Diagnosis and classification of diabetes mellitus. Diabetes Care, 33, e57.","DOI":"10.2337\/dc09-2368"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1001\/jama.291.7.870","article-title":"Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest","volume":"291","author":"Booth","year":"2004","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/j.1399-6576.2009.02021.x","article-title":"Outcome, timing and adverse events in therapeutic hypothermia after out-of-hospital cardiac arrest","volume":"53","author":"Nielsen","year":"2009","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s00134-014-3269-9","article-title":"Blood glucose level and outcome after cardiac arrest: Insights from a large registry in the hypothermia era","volume":"40","author":"Daviaud","year":"2014","journal-title":"Intensive Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.resuscitation.2009.02.011","article-title":"Derangements in blood glucose following initial resuscitation from in-hospital cardiac arrest: A report from the national registry of cardiopulmonary resuscitation","volume":"80","author":"Beiser","year":"2009","journal-title":"Resuscitation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1097\/CCM.0000000000002367","article-title":"Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33 degrees C and 36 degrees C","volume":"45","author":"Borgquist","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1097\/CCM.0000000000001815","article-title":"Liberal glycemic control in critically ill patients with type 2 diabetes: An exploratory study","volume":"44","author":"Kar","year":"2016","journal-title":"Crit. Care Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1097\/CCM.0000000000003087","article-title":"Liberal glucose control in ICU patients with diabetes: A before-and-after study","volume":"46","author":"Luethi","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1111\/aas.13354","article-title":"Hospital-acquired complications in intensive care unit patients with diabetes: A before-and-after study of a conventional versus liberal glucose control protocol","volume":"63","author":"Luethi","year":"2019","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1056\/NEJMoa1204942","article-title":"Hypoglycemia and risk of death in critically ill patients","volume":"367","author":"Investigators","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1007\/s00134-018-5453-9","article-title":"Targeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation: A randomised pilot trial","volume":"44","author":"Jakkula","year":"2018","journal-title":"Intensive Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.resuscitation.2016.03.023","article-title":"Targeted therapeutic mild hypercapnia after cardiac arrest: A phase II multi-centre randomised controlled trial (the CCC trial)","volume":"104","author":"Eastwood","year":"2016","journal-title":"Resuscitation"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wiberg, S., Hassager, C., Stammet, P., Winther-Jensen, M., Thomsen, J.H., Erlinge, D., Wanscher, M., Nielsen, N., Pellis, T., and Aneman, A. (2017). Single versus Serial Measurements of Neuron-Specific Enolase and Prediction of Poor Neurological Outcome in Persistently Unconscious Patients after Out-Of-Hospital Cardiac Arrest\u2014A TTM-Trial Substudy. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0168894"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/9\/1480\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:21:11Z","timestamp":1760188871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/9\/1480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,18]]},"references-count":27,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["jcm8091480"],"URL":"https:\/\/doi.org\/10.3390\/jcm8091480","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2019,9,18]]}}}