The Prognosis of Cardiac Origin and Noncardiac Origin in-Hospital Cardiac Arrest Occurring during Night Shifts

Abstract

Background. The survival rates of in-hospital cardiac arrests (IHCAs) are reportedly low at night, but the difference between the survival rates of cardiac origin and noncardiac origin IHCAs occurring at night remains unclear. Methods. Outcomes of IHCAs during different shifts (night, day, and evening) were compared and stratified according to the etiology (cardiac and noncardiac origin). Result. The rate of return of spontaneous circulation (ROSC) was 24.7% lower for cardiac origin IHCA and 19.4% lower for noncardiac origin IHCA in the night shift than in the other shifts. The survival rate was 8.4% lower for cardiac origin IHCA occurring during the night shift, but there was no difference for noncardiac origin IHCA. After adjusting the potential confounders, chances of ROSC (aOR: 0.3, CI: 0.15–0.63) and survival to discharge (aOR: 0.1; CI: 0.01–0.90) related to cardiac origin IHCA were lower during night shifts. Regarding noncardiac origin IHCA, chances of ROSC (aOR: 0.5, CI: 0.30–0.78) were lower in the night shift, but chances of survival to discharge (aOR: 1.3, CI: 0.43–3.69) were similar in these two groups. Conclusion. IHCA occurring at night increases mortality, and this is more apparent for cardiac origin IHCAs than for noncardiac origin IHCA.

ROSC rates and live discharge rates after cardiopulmonary resuscitation by different CPR teams - a retrospective cohort study

“…Previous studies have reported that hospitals tend to attend to patients with a greater severity of illness at night; hence, the in-hospital CPR conducted during the night yielded lower ROSC rates [ 10 ]. Further, because these studies [ 11 , 12 ] analyzed the nighttime or weekend effects within the same CPR system, it is likely that patient-related factors and fatigue levels of the medical staff contributed to the lower ROSC rates.. In our study, it is unlikely that severity of illness contributed to the differences in the CPR outcomes; this is supported by the non-significant differences in the Charlson comorbidity scores between the three teams.…”

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

“…Our findings are similar to those from previous studies, which showed that patients were more likely to require CPR and were more likely to experience the poorest outcomes during the night. [ 16 , 17 ] In addition, the ROSC rate of CPR did not vary across seasons or years but did vary by time of day. A previous study [ 17 ] showed that the ROSC rates were lower during the night than during the day for both cardiac and respiratory arrest.…”

“…[ 16 , 17 ] In addition, the ROSC rate of CPR did not vary across seasons or years but did vary by time of day. A previous study [ 17 ] showed that the ROSC rates were lower during the night than during the day for both cardiac and respiratory arrest. Furthermore, ROSC rates were lower for CPR performed on Sundays and for female patients.…”

Correlation between Patient’s Age and Advanced Response Time with Outcome of Cardio Pulmonary Resuscitation in Cardiac Arrest Patient

“…It is similar with the study conducted in Brazil which showed that 70.5% of cardiac arrest patients are over 40 years old and 29,5% of cardiac arrest patients are less than or equal to 40 years old. 9,10 This can occur because by increasing the patient's age, the risk of experiencing comorbid diseases or terminal diseases is also getting bigger. 1,11 Statistically, the patient's age did not show a significant difference towards outcome in cardiac arrest patients.…”