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

Bagai, Akshay; McNally, Bryan; Al‐Khatib, Sana M.; Myers, Jesse; Kim, Sunghee; Karlsson, Lena; Torp‐Pedersen, Christian; Wissenberg, Mads; Diepen, Sean van; Fosbøl, Emil Loldrup; Monk, Lisa; Abella, Benjamin S.; Granger, Christopher B.; Jollis, James G.

doi:10.1161/circulationaha.113.004164

Cited by 109 publications

(98 citation statements)

References 34 publications

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“…In our study, the arrival time was 9 min. This result is comparable to international data [7,9,14,[18][19][20]29].…”

Section: Resultssupporting

confidence: 90%

“…Moreover, the described circumstances of OHCA are consistent: cardiac arrest usually occurs at home (60-80%) in the presence of witnesses (up to 90%) and with other mechanisms than VT/VF (up to 90%) [8,11,[14][15][16][18][19][20][21]. CPR is undertaken by approximately half of the witnesses.…”

Section: Resultsmentioning

confidence: 99%

“…There are interesting observations which state that OHCA occurrence may vary with time of day, day of the week, and month of the year [11,14,18]. The differences may be related to the chronobiology of the reasons for OHCA (mainly cardiologic background) and weather conditions [27].…”

Section: Resultsmentioning

confidence: 99%

“…The differences may be related to the chronobiology of the reasons for OHCA (mainly cardiologic background) and weather conditions [27]. Circadian patterns in OHCA and its outcomes may depend on acute changes in some biological triggers, including blood pressure and heart rate, vascular tone, blood pressure, heart rate variability, blood viscosity, and platelet aggregation [18,27]. Seasonal variations may in turn depend on relative changes in the climate and weather (temperature, humidity), which are occasionally strengthened by important behavioural changes, including stress before and after holidays or seasonal migrations [27,28].…”

Section: Resultsmentioning

confidence: 99%

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Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis

2016

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A b s t r a c tBackground: Out-of-hospital cardiac arrest (OHCA) is the sudden, unexpected loss of heart function, which occurs out of specialist healthcare facilities and inevitably leads to death if uninterrupted by effective cardiopulmonary resuscitation (CPR). Aim:To evaluate the circumstances and basic epidemiological indices of OHCA in the population of adult inhabitants of Bielsko-Biala district within 12 months. Methods:On the basis of standard ambulance dispatch cards of the Emergency Medical Services (EMS) teams, a retrospective analysis was made of 272 OHCA cases covering the period from 01.01.2013 to 31.12.2013. We assessed the basic demographic data of the victims, circumstances of the occurrence of OHCA, information on the potential cause and mechanism of the OHCA, and data related to the actions undertaken by witnesses and EMS teams. Results:The overall OHCA incidence was 170/100,000 (243/100,000 in men; 99/100,000 in women). It increased with subjects' age (p < 0.01). The most frequent place of OHCA was the victim's home (82%). OHCA occurred in the presence of witnesses in 60% of cases. CPR was undertaken by a witness in 56% cases. Median CPR duration undertaken by a witness was 10 (IQR 8-14) min. Median time from notification receipt by the EMS to the team arrival was 9 (7-11) min. On the scene, defibrillation rhythm was recognised in 39% of cases. Sixty-seven patients were declared deceased after the arrival of the EMS teams. In the remaining 205 cases, CPR was undertaken, which was ineffective for 141 persons. Median CPR duration undertaken by the EMS team was 30 (20-40) min. The overall prehospital case fatality ratio was 76.5% (75.3% for men; 79.3% for women).Conclusions: OHCA incidence in the Bielsko-Biala population in 2013 was high, increased with age, and was twice as high for men than women. OHCA occurred most often at home, in the presence of a witness; however, CPR was not always undertaken promptly at the scene. CPR was effective for approximately 30% of the victims. The prehospital mortality was high with no differences between genders.

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“…In our study, the arrival time was 9 min. This result is comparable to international data [7,9,14,[18][19][20]29].…”

Section: Resultssupporting

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis

2016

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“…For example, the incidence of cardiac arrests is known to be related to ambient climate conditions, namely low temperatures, which consequently increase the risk of heart disease and the number of OHCA cases during winter seasons 2,3 . This association concurs with official statistics reported at a Fire and Disaster Management conference on the practical applications of emergency statistics.…”

Section: Introductionmentioning

confidence: 99%

The daily incidence of out-of-hospital cardiac arrest unexpectedly increases around New Year's Day in Japan

Takahashi

Shimadzu

2015

Resuscitation

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Survival Rates Following Pediatric In-Hospital Cardiac Arrests During Nights and Weekends

et al. 2017

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IMPORTANCE Nearly 6000 hospitalized children in the United States receive cardiopulmonary resuscitation (CPR) annually. Little is known about whether the survival of these children is influenced by the time of the event (eg, nighttime or weekends). Differences in survival could have important implications for hospital staffing, training, and resource allocation.OBJECTIVE To determine whether outcomes after pediatric in-hospital cardiac arrests differ during nights and weekends compared with days/evenings and weekdays. DESIGN, SETTING, AND PARTICIPANTSThis study included a total of 354 hospitals participating in the American Heart Association's Get With the Guidelines-Resuscitation registry from January 1, 2000, to December 12, 2012. Index cases (12 404 children) from all children younger than 18 years of age receiving CPR for at least 2 minutes were included. Data analysis was performed in December 2014 and June 2016. We aggregated hourly blocks of time, using previously defined time intervals of day/evening and night, as well as weekend. Multivariable logistic regression models were used to examine the effect of independent variables on survival to hospital discharge. We used a combination of a priori variables based on previous literature (including age, first documented rhythm, location of event in hospital, extracorporeal CPR, and hypotension as the cause of arrest), as well as variables that were identified in bivariate generalized estimating equation models, and maintained significance of P Յ .15 in the final multivariable models. MAIN OUTCOMES AND MEASURESThe primary outcome measure was survival to hospital discharge, and secondary outcomes included return of circulation lasting more than 20 minutes and 24-hour survival.RESULTS Of 12 404 children (56.0% were male), 8731 (70.4%) experienced a return of circulation lasting more than 20 minutes, 7248 (58.4%) survived for 24 hours, and 4488 (36.2%) survived to hospital discharge. After adjusting for potential confounders, we found that the rate of survival to hospital discharge was lower during nights than during days/evenings (adjusted odds ratio, 0.88 [95% CI, 0.80-0.97]; P = .007) but was not different between weekends and weekdays (adjusted odds ratio, 0.92 [95% CI, 0.84-1.01]; P = .09). CONCLUSIONS AND RELEVANCEThe rate of survival to hospital discharge was lower for pediatric CPR events occurring at night than for CPR events occurring during daytime and evening hours, even after adjusting for many potentially confounding patient-, event-, and hospital-related factors.

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

Abstract: Background-Understanding temporal differences in the incidence and outcomes of out-of-hospital cardiac arrest (OHCA) has important implications for developing preventative strategies and optimizing systems for OHCA care.

Cited by 109 publications

References 34 publications

Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis

Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis

The daily incidence of out-of-hospital cardiac arrest unexpectedly increases around New Year's Day in Japan

Survival Rates Following Pediatric In-Hospital Cardiac Arrests During Nights and Weekends

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