• Bo-Yeong Jin, Juhyun Song, Jooyeong Kim, Jong-Hak Park, Sung Jin Kim, Hanjin Cho, Sungwoo Moon, Dong-Hoon Kim, and Sejoong Ahn.
• Department of Pharmacology, Korea University College of Medicine, Seoul, Republic of Korea.
• J Crit Care. 2023 Feb 1; 73: 154171154171.

IntroductionMetformin has shown cardioprotective and neuroprotective effects in cardiac arrest and ischemia-reperfusion injury animal models. Therefore, this study aimed to determine the association between diabetes medication and survival outcomes in in-hospital cardiac arrest (IHCA) patients with type 2 DM (T2DM).MethodsThis retrospective observational study included adult IHCA patients with T2DM between April 2017 and March 2022. The variable of interest was administration of diabetes medications within 24 h before cardiac arrest. Multivariable logistic regression analysis was performed.ResultsIn the 377 included patients, administration of metformin within 24 h before IHCA was associated with a higher rate of survival to discharge and good neurologic outcome (41.5% vs 11.7%, P < 0.001 and 18.9% vs 6.2%, P = 0.004, respectively). Administration of metformin within 24 h before IHCA was independently associated with survival to discharge and good neurologic outcome (aOR: 5.37, 95% CI: 2.13-13.53, P < 0.001 and aOR: 3.57, 95% CI: 1.14-11.17, P = 0.029). The rate of survival to discharge was the highest in patients who were administered 500-1000 mg/day metformin (P < 0.001).ConclusionsIn IHCA patients with T2DM, administration of metformin within 24 h before IHCA was independently associated with survival to discharge.Copyright © 2022 Elsevier Inc. All rights reserved.

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