Journal article
Trends in Survival After In-Hospital Cardiac Arrest During Nights and Weekends
Journal of the American College of Cardiology, Vol.71(4), pp.402-411
01/30/2018
DOI: 10.1016/j.jacc.2017.11.043
PMCID: PMC5858924
PMID: 29389356
Abstract
BACKGROUND Survival after in-hospital cardiac arrest (IHCA) is lower during nights and weekends (off-hours) compared with daytime during weekdays (on-hours). As overall IHCA survival has improved over time, it remains unknown whether survival differences between on-hours and off-hours have changed.
OBJECTIVES This study sought to examine temporal trends in survival differences between on-hours and off-hours IHCA.
METHODS We identified 151,071 adults at 470 U.S. hospitals in the Get with the Guidelines-Resuscitation registry during 2000 to 2014. Using multivariable logistic regression with generalized estimating equations, we examined whether survival trends in IHCA differed during on-hours (Monday to Friday 7: 00 AM to 10: 59 PM) versus off-hours (Monday to Friday 11: 00 PM to 6: 59 AM, and Saturday to Sunday, all day).
RESULTS Among 151,071 participants, 79,091 (52.4%) had an IHCA during off-hours. Risk-adjusted survival improved over time in both groups (on-hours: 16.0% in 2000, 25.2% in 2014; off-hours: 11.9% in 2000, 21.9% in 2014; p for trend <0.001 for both). However, there was no significant change in the survival difference over time between on-hours and off-hours, either on an absolute (p = 0.75) or a relative scale (p = 0.059). Acute resuscitation survival improved significantly in both groups (on-hours: 56.1% in 2000, 71% in 2014; off-hours: 46.9% in 2000, 68.2% in 2014; p for trend <0.001 for both) and the difference between on-hours and off-hours narrowed over time (p = 0.02 absolute scale, p <0.001 relative scale). In contrast, although post-resuscitation survival also improved over time in both groups (p for trend <0.001 for both), the absolute and relative difference persisted.
CONCLUSIONS Despite an overall improvement in survival, lower survival in IHCA during off-hours compared with on-hours persists. (C) 2018 by the American College of Cardiology Foundation.
Details
- Title: Subtitle
- Trends in Survival After In-Hospital Cardiac Arrest During Nights and Weekends
- Creators
- Uchenna R. Ofoma - Geisinger Health SystemSuresh Basnet - Winchester Medical CenterAndrea Berger - Geisinger Health SystemH. Lester Kirchner - Geisinger Health SystemSaket Girotra - University of Iowa Hospitals and ClinicsAmerican Heart Association Get With the Guidelines – Resuscitation Investigators
- Contributors
- Boulos S Nassar (Contributor) - University of Iowa, Internal Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Cardiology, Vol.71(4), pp.402-411
- DOI
- 10.1016/j.jacc.2017.11.043
- PMID
- 29389356
- PMCID
- PMC5858924
- NLM abbreviation
- J Am Coll Cardiol
- ISSN
- 0735-1097
- eISSN
- 1558-3597
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- SRC-S-43 / Geisinger Health System Foundation K08HL122527 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI)
- Language
- English
- Date published
- 01/30/2018
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359895102771
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