Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: a prospective observational study. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Matsumura, Yosuke; Nakada, Taka-aki; Shinozaki, Koichiro; Tagami, Takashi; Nomura, Tomohisa; Tahara, Yoshio; Sakurai, Atsushi; Yonemoto, Naohiro; Nagao, Ken; Yaguchi, Arino; Morimura, Naoto
• Is Part Of: Critical care. Volume 20:Issue 1(2016)
• Page Start: 1
• Page End: 8
• Publication Date: 2016-12
• Subjects: Cardiopulmonary resuscitation -- Circadian rhythm -- Heart arrest -- Resuscitation -- Out-of-hospital cardiac arrest; Critical care medicine -- Periodicals; 616.02805
• DOI: 10.1186/s13054-016-1323-4
• Languages: English
• ISSNs: 1364-8535

Abstract

Abstract Background Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results During the study period, 13, 780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34–2.07;P < 0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93–0.96; bystander CPR: OR 0.85 and 95 % CI 0.78–0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74–0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75–0.98). Conclusions There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.