# Analysis of Factors Associated with Hypoglycemia in Patients with Out-of-Hospital Cardiac Arrest Undergoing Targeted Temperature Management

## TL;DR

This study identifies factors linked to low blood sugar in cardiac arrest patients undergoing temperature control treatment.

## Contribution

The study identifies BMI, NT-proBNP levels, and renal replacement therapy as novel predictors of hypoglycemia in OHCA patients undergoing TTM.

## Key findings

- 13.2% of OHCA patients undergoing TTM developed hypoglycemia.
- Lower BMI, elevated NT-proBNP, and renal replacement therapy were independently associated with hypoglycemia.
- The predictive model for hypoglycemia had an area under the curve of 0.801.

## Abstract

Background: Patients with out-of-hospital cardiac arrest (OHCA) are susceptible to hypoglycemia, which may worsen outcomes. Early identification of patients at risk is therefore essential. This study examined factors associated with hypoglycemia in OHCA survivors treated with targeted temperature management (TTM). Methods: We conducted an observational study of adults (≥18 years) with OHCA who received TTM between October 2015 and December 2024. Hypoglycemia was defined as blood glucose ≤ 70 mg/dL, assessed within 7 days of admission. The primary outcome was hypoglycemia occurrence. Results: Among 521 patients with OHCA, 69 (13.2%) developed hypoglycemia. Multivariable analysis identified body mass index (odds ratio [OR], 0.877; 95% confidence interval [CI], 0.808–0.953), N-terminal pro-B-type natriuretic peptide (NT-proBNP) > 2000 mg/dL (OR, 3.769; 95% CI, 2.060–6.898), and renal replacement therapy (OR, 3.429; 95% CI, 1.841–6.387) as independent factors associated with hypoglycemia. The area under the curve for the final adjusted model was 0.801 (95% CI, 0.764–0.835). Conclusions: In the OHCA patients who received TTM, body mass index, NT-proBNP > 2000, and renal replacement therapy were associated with hypoglycemia.