A comparative study of the incidence of in-hospital cardiopulmonary resuscitation on Monday–Wednesday and Thursday–Sunday

Oh, Tak Kyu; Park, Young Mi; Hwan, Sang; Hwang, Jung Won; Jo, You Hwan; Kim, Jin Hee; Jeon, Young Tae; Song, In Ae

doi:10.1097/md.0000000000009741

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…As reported previously 21 , the average number of ICPR performed for IHCA cases per 1000 patients per month was 4.22 (SD: 1.13) from 2007 to 2016. The initial ROSC rate following ICPR from IHCA was reported to be 72.3% from 2012 to 2016 22 . A rapid response system has been in place since 2013 to reduce the incidence of IHCA at SNUBH 23 , and ICPR has been performed for IHCA by both the rapid response system and an on-duty resident team 24 .…”

Section: Methodsmentioning

confidence: 99%

Two-dimensional echocardiography after return of spontaneous circulation and its association with in-hospital survival after in-hospital cardiopulmonary resuscitation

Song

Kwon

et al. 2020

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this retrospective cohort study investigated the association between in-hospital survival and twodimensional (2D) echocardiography within 24 hours after the return of spontaneous circulation (ROSC) in patients who underwent in-hospital cardiopulmonary resuscitation (ICPR) after in-hospital cardiopulmonary arrest (IHCA). The 2D-echo and non-2D-echo groups comprised eligible patients who underwent transthoracic 2D echocardiography performed by the cardiology team within 24 hours after ROSC and those who did not, respectively. After propensity score (PS) matching, 142 and 284 patients in the 2D-echo and non-2D-echo groups, respectively, were included. A logistic regression analysis showed that the likelihood of in-hospital survival was 2.35-fold higher in the 2D-echo group than in the non-2D-echo group (P < 0.001). Regarding IHCA aetiology, in-hospital survival after cardiac arrest of a cardiac cause was 2.51-fold more likely in the 2D-echo group than in the non-2D-echo group (P < 0.001), with no significant inter-group difference in survival after cardiac arrest of a non-cardiac cause (P = 0.120). In this study, 2D echocardiography performed within 24 hours after ROSC was associated with better in-hospital survival outcomes for patients who underwent ICPR for IHCA with a cardiac aetiology. Thus, 2D echocardiography may be performed within 24 hours after ROSC in patients experiencing IHCA to enable better treatment.In-hospital cardiac arrest (IHCA) is an important determinant of in-hospital mortality 1 . According to recent reports, 290,000 cases of IHCA occur annually in the U.S 2 . Among these, approximately 2.73 patients per 1000 patients with IHCA who undergo in-hospital cardiopulmonary resuscitation (ICPR) are elderly inpatients 3,4 . Despite steady increases in the post-IHCA survival rate due to improvements in the quality of patient care 5 , survival remains a significant challenge in this population 2 .Two-dimensional (2D) echocardiography is a rapid, safe, and non-invasive modality used to examine the motion of the heart. In addition to its usefulness for treating and evaluating patients in intensive care unit (ICU) settings 6 , 2D echocardiography has been reported to play a major role in vasopressor dose adjustments or fluid management during the treatment of patients with shock 7,8 . In patients with IHCA, 2D echocardiography has been shown to facilitate the rapid detection or exclusion of various aetiologies during the peri-resuscitative period and to help physicians identify targets for possible correction 9 . Furthermore, 2D echocardiography is useful for the diagnosis and treatment of post-arrest myocardial dysfunction (PAMD), a common condition affecting patients who achieve return of spontaneous circulation (ROSC) after IHCA 10-12 . Accordingly, 2D echocardiography may be useful for improving post-ROSC survival for patients who undergo ICPR for IHCA. However, available information related to this topic remains insufficient.Therefore, this study aimed to investigate the association between in-hospit...

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Section: Methodsmentioning

confidence: 99%

Two-dimensional echocardiography after return of spontaneous circulation and its association with in-hospital survival after in-hospital cardiopulmonary resuscitation

Song

Kwon

et al. 2020

Sci Rep

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“…Particularly, reduced hospital staffing on the weekend and the effect of this factor on hospital care were reported to be associated with increased mortality in hospitalized patients 23,24 . In a recent cohort study conducted at a single tertiary academic hospital in South Korea, the incidence of in‐hospital cardiopulmonary arrest was higher during Thursday–Sunday than during Monday–Wednesday, 25 suggesting that the reduced hospital staff during the weekend or later in the week might have a negative effect on the outcomes of hospitalized patients. Postoperative complications, including fatal events, occur commonly after cardiac surgery, 26 and the staffing of experienced intensivists during nighttime or weekend shifts was shown to improve patient outcomes after postoperative cardiac surgery 27 .…”

Section: Discussionmentioning

confidence: 99%

Association between the weekday on which coronary artery bypass graft surgery is performed and the 30‐day mortality: A nationwide cohort study in South Korea

Song

2021

J Card Surg

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Background: Postoperative mortality associated with elective coronary artery bypass graft (CABG) surgery may reportedly increase as the weekday of surgery approaches the weekend. We aimed to investigate the potential effect of the weekday of CABG surgery on the 30-day mortality. Methods: This population-based cohort study analyzed data obtained from the South Korea national health insurance service database. The cohort included all adult patients diagnosed with ischemic heart disease (International Classification of Diseases-10 codes I20*-I25*) who underwent isolated and elective CABG surgery from January 2012 to December 2017. Results: Of the 13,556 patients included in the analysis, 595 (4.4%) died within 30 days after CABG surgery. In a multivariable Cox model, the 30-day mortality of patients who underwent CABG surgery later in the week (Wednesday-Friday) was not significantly associated with the weekday of surgery as similar to those who underwent surgery early in the week (Monday-Tuesday) (hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 0.97-1.34; p = .109). Multivariable sensitivity analysis revealed that CABG surgery on Friday was associated with a 1.40-fold higher hazard of 30-day mortality (HR: 1.40; 95% CI: 1.09-1.80; p = .008) than CABG surgery on Monday. Conclusions: This South Korean population-based cohort study revealed that relative to surgery early in the week (Monday-Tuesday), CABG surgery later in the week (Wednesday-Friday) was not associated with higher 30-day mortality. However, using surgery on Monday as a reference, CABG surgery on Friday was associated with higher 30-day mortality. Future studies must confirm these findings.

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“…The "weekend effect" on ICPR implies that the patients who undergo ICPR on the weekend would be associated with worse clinical outcomes after ICPR compared to those who undergo ICPR on weekdays (3)(4)(5)(6). We previously analyzed 1195 in-hospital CPR cases and studied CPRs by day of the week, and observed that the occurrence of intra-hospital CPRs varied by Mondays-Wednesdays and Thursdays-Sundays, and that the return of spontaneous circulation (ROSC) rate of ICPRs occurring on Sundays was low even after correction (3). In a study using data from a multicenter or regional ICPR registry, patients who received ICPR on weekends/nights were associated with lower survival to discharge (5,(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Weekend effect on the mortality rate of in-hospital cardiopulmonary resuscitations from 2010 through 2019: a retrospective population-based cohort study

Oh¹,

Jo²,

Song³

2022

Ann Palliat Med

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Background: A smaller number of in-hospital medical staff and professionals on the weekend may lead to worsened survival outcomes in patients who have receive in-hospital cardiopulmonary resuscitation (ICPR).However, information regarding the effect of the weekend on survival outcomes after ICPR remains lacking.Therefore, we aimed to evaluate the "weekend effect" on the 6-month and 1-year mortality after ICPR.Methods: This population-based cohort study was based on data extracted from the National Health Insurance Service database in South Korea. We enrolled 298,676 adult (≥18 years old) patients who had experienced ICPR due to in-hospital cardiac arrest (IHCA) between January 1, 2010, and December 31, 2019. The primary endpoints were 6-month and 1-year mortality after ICPR. Propensity score matching (PSM) was used to adjust clinical covariates. Results:The survival analysis before and after PSM, 6-month mortality [pre-PSM hazard ratio (HR) =1.04, 95% confidence interval (CI): 1.03-1.04, P<0.001; post-PSM HR =1.02, 95% CI: 1.01-1.03, P<0.001], and 1 year mortality (pre-PSM HR =1.03, 95% CI: 1.03-1.04, P<0.001; post-PSM HR =1.02, 95% CI: 1.01-1.03, P<0.001) of the patients who received ICPR on weekends was higher than those on weekdays. The results of the multivariable Cox regression model for 1-year mortality among the entire cohort indicated that there were significant associations between high 1-year mortality after ICPR and the confounders (weekend vs.

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A comparative study of the incidence of in-hospital cardiopulmonary resuscitation on Monday–Wednesday and Thursday–Sunday

Abstract: Supplemental Digital Content is available in the text

Cited by 5 publications

References 16 publications

Two-dimensional echocardiography after return of spontaneous circulation and its association with in-hospital survival after in-hospital cardiopulmonary resuscitation

Two-dimensional echocardiography after return of spontaneous circulation and its association with in-hospital survival after in-hospital cardiopulmonary resuscitation

Association between the weekday on which coronary artery bypass graft surgery is performed and the 30‐day mortality: A nationwide cohort study in South Korea

Weekend effect on the mortality rate of in-hospital cardiopulmonary resuscitations from 2010 through 2019: a retrospective population-based cohort study

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