Increased Occurrence of Out‐of‐Hospital Cardiac Arrest on Mondays in a Community‐Based Study

Abstract

Acute myocardial infarction and sudden cardiac death are more common on Mondays than other days of the week. The stress of returning to work at the beginning of the week has been postulated as a possible trigger factor. This project examined the weekly variation of out-of-hospital cardiac arrests of nontraumatic origin for the entire case series as well as for selected subgroups. A retrospective analysis of 1,498 incidences between January 1, 1995 and December 31, 1996 revealed a distinct Monday peak in occurrence irrespective of age, gender, presence of witnesses, primary survival, or primary ECG. This finding, however, was most pronounced in retired patients, subjects living alone, and persons found unconscious outside buildings or in public places. One important trigger of cardiac arrest is going to work after weekends; however, resumption of social and other activities on Mondays is another possible trigger. Other factors, such as endogenous biological rhythms, may contribute to an increased risk at this particular time even in elderly.

Seasonal variations in the occurrence of acute myocardial infarction in Hungary between 2000 and 2004

“…It has also been found that if the first day of the week (Monday) is a holiday, for example Easter or White Monday, the incidence of events is significantly lower. Some researchers found that the Monday peak is most pronounced in the working population [9,21]. Differentiation between actively working or inactive patients could not be made in our present database.…”

Heart rate variability related to effort at work

“…Thus, the results do not reflect accumulating work stress and workload during the work period. The slight but significant increase in relaxation percentage from Day 1 to Day 2 might rather relate to the increased stress of returning to work in the beginning of the week (Gruska et al, 2005). In contrast to that, the activity score from wrist movement for Day 2 was even slightly higher than for Day 1 meaning that differences in physical activity cannot explain this finding.…”

Temporal Differences in Out-of-Hospital Cardiac Arrest Incidence and Survival

“…9,10,25,26 Although the reasons remain speculative, changes in behavior around weekends, including alcohol intake, sleep/wake cycle, and physical activity may partly explain this observation. 27 In contrast to previous studies, 8 we did not observe significant variability in survival after OHCA by day of week.…”