Survival From In-Hospital Cardiac Arrest During Nights and Weekends

Abstract

HE INSTITUTE OF MEDICINE RE-ports that as many as 98 000 preventable in-hospital deaths occur annually. 1 Diagnostic, treatment, preventive, and other system errors have been identified as focus areas to prevent medical injury. 2 The detection and treatment of arrests and their antecedents may be less effective at night because of patient, event, hospital, staffing, and response factors. If in-hospital cardiac arrests are more common or survival is worse on nights and weekends, this information could have important implications for hospital staffing, training, care delivery processes, and equipment decisions.We evaluated survival rates for adults with in-hospital cardiac arrest by time of day and day of week. We hypothesized that outcome after cardiac arrest would be worse during nights and weekends, even when adjusted for potentially confounding patient, event, and hospital factors.

Clinical characteristics, causes and predictors of outcomes in patients with in-hospital cardiac arrest: results from the SURVIVE-ARREST study

“…In contrast to other recent studies, we found a lower risk of 30-day in-hospital mortality during night hours in comparison with events that occurred during the dayshift [ 38 ]. The importance of sex to outcomes has attracted some attention, with previous studies showing better survival in female vs. male patients post IHCA [ 26 ].…”

Extracorporeal cardiopulmonary resuscitation in refractory intra‐operative cardiac arrest: an observational study of 12‐year outcomes in a single tertiary hospital

“…In our study, extracorporeal CPR outside of regular working hours or during emergency operations had a higher survival rate than those during regular working hours or elective surgery. These results appear to be inconsistent with the results of previous studies that reported lower survival rates during the night hours and at weekends . These differences might influence the different characteristics of patients enrolled in our analysis.…”

Multicenter cohort study of out-of-hospital pediatric cardiac arrest*

“…Possible explanations might be the greater availability of adult caregivers during weekends or less traffic and quicker response times by EMS. This is in contrast to observations in adults with in-hospital cardiac arrest, where higher mortality on weekends and night shifts has been demonstrated (25). …”