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

Akshay Bagai; Bryan F McNally; Sana M Al-Khatib; J Brent Myers; Sunghee Kim; Lena Karlsson; Christian Torp-Pedersen; Mads Wissenberg; Sean van Diepen; Emil L Fosbol; Lisa Monk; Benjamin S Abella; Christopher B Granger; James G Jollis

doi:10.1161/circulationaha.113.004164

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

Bidragets oversatte titel: Temporal Differences in Out-of-Hospital Cardiac Arrest Incidence and Survival

Akshay Bagai, Bryan F McNally, Sana M Al-Khatib, J Brent Myers, Sunghee Kim, Lena Karlsson, Christian Torp-Pedersen, Mads Wissenberg, Sean van Diepen, Emil L Fosbol, Lisa Monk, Benjamin S Abella, Christopher B Granger, James G Jollis

63 Citationer (Scopus)

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. Methods and Results-We studied 18 588 OHCAs of presumed cardiac origin in patients aged =18 years who received resuscitative efforts by emergency medical services (EMS) and were enrolled in the Cardiac Arrest Registry to Enhance Survival (CARES) from October 1, 2005, to December 31, 2010. We evaluated temporal variability in OHCA incidence and survival to hospital discharge. There was significant variability in the frequency of OHCA by hour of the day (P<0.001), day of the week (P<0.001), and month of the year (P<0.001), with the highest incidence occurring during the daytime, from Friday to Monday, in December. Survival to hospital discharge was lowest for OHCA that occurred overnight (from 11:01 pm to 7 am; 7.1%) versus daytime (7:01 am to 3 pm; 10.8%) or evening (3:01 pm to 11 pm; 11.3%; P<0.001) and during the winter (8.8%) versus spring (11.1%), summer (11.0%), or fall (10.0%; P<0.001). There was no difference in survival to hospital discharge between OHCAs that occurred on weekends and weekdays (9.5% versus 10.4%, P=0.06). After multivariable adjustment for age, sex, race, witness status, layperson resuscitation, first monitored cardiac rhythm, and emergency medical services response time, compared with daytime and spring, survival to hospital discharge remained lowest for OHCA that occurred overnight (odds ratio, 0.81; 95% confidence interval, 0.70-0.95; P=0.008) and during the winter (odds ratio, 0.81; 95% confidence interval, 0.70-0.94; P=0.006), respectively. Conclusions-There is significant temporal variability in the incidence of and survival after OHCA. The relative contribution of patient pathophysiology, likelihood of the OHCA being observed, and prehospital and hospital-based resuscitative factors deserves further exploration.

Bidragets oversatte titel	Temporal Differences in Out-of-Hospital Cardiac Arrest Incidence and Survival
Originalsprog	Engelsk
Tidsskrift	Circulation
Vol/bind	128
Udgave nummer	24
Sider (fra-til)	2595-2602
Antal sider	8
ISSN	0009-7322
DOI	https://doi.org/10.1161/circulationaha.113.004164
Status	Udgivet - 17 dec. 2013

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10.1161/circulationaha.113.004164

Citationsformater

Bagai, A., McNally, B. F., Al-Khatib, S. M., Myers, J. B., Kim, S., Karlsson, L., Torp-Pedersen, C., Wissenberg, M., van Diepen, S., Fosbol, E. L., Monk, L., Abella, B. S., Granger, C. B., & Jollis, J. G. (2013). Temporal Differences in Out-of-Hospital Cardiac Arrest Incidence and Survival. Circulation, 128(24), 2595-2602. https://doi.org/10.1161/circulationaha.113.004164

@article{49fafc5d8c05491fb5d9ef7f0e393485,

title = "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. Methods and Results-We studied 18 588 OHCAs of presumed cardiac origin in patients aged =18 years who received resuscitative efforts by emergency medical services (EMS) and were enrolled in the Cardiac Arrest Registry to Enhance Survival (CARES) from October 1, 2005, to December 31, 2010. We evaluated temporal variability in OHCA incidence and survival to hospital discharge. There was significant variability in the frequency of OHCA by hour of the day (P<0.001), day of the week (P<0.001), and month of the year (P<0.001), with the highest incidence occurring during the daytime, from Friday to Monday, in December. Survival to hospital discharge was lowest for OHCA that occurred overnight (from 11:01 pm to 7 am; 7.1%) versus daytime (7:01 am to 3 pm; 10.8%) or evening (3:01 pm to 11 pm; 11.3%; P<0.001) and during the winter (8.8%) versus spring (11.1%), summer (11.0%), or fall (10.0%; P<0.001). There was no difference in survival to hospital discharge between OHCAs that occurred on weekends and weekdays (9.5% versus 10.4%, P=0.06). After multivariable adjustment for age, sex, race, witness status, layperson resuscitation, first monitored cardiac rhythm, and emergency medical services response time, compared with daytime and spring, survival to hospital discharge remained lowest for OHCA that occurred overnight (odds ratio, 0.81; 95% confidence interval, 0.70-0.95; P=0.008) and during the winter (odds ratio, 0.81; 95% confidence interval, 0.70-0.94; P=0.006), respectively. Conclusions-There is significant temporal variability in the incidence of and survival after OHCA. The relative contribution of patient pathophysiology, likelihood of the OHCA being observed, and prehospital and hospital-based resuscitative factors deserves further exploration.",

author = "Akshay Bagai and McNally, {Bryan F} and Al-Khatib, {Sana M} and Myers, {J Brent} and Sunghee Kim and Lena Karlsson and Christian Torp-Pedersen and Mads Wissenberg and {van Diepen}, Sean and Fosbol, {Emil L} and Lisa Monk and Abella, {Benjamin S} and Granger, {Christopher B} and Jollis, {James G}",

year = "2013",

month = dec,

day = "17",

doi = "10.1161/circulationaha.113.004164",

language = "English",

volume = "128",

pages = "2595--2602",

journal = "Circulation",

issn = "0009-7322",

publisher = "AHA/ASA",

number = "24",

}

TY - JOUR

T1 - Temporal Differences in Out-of-Hospital Cardiac Arrest Incidence and Survival

AU - Bagai, Akshay

AU - McNally, Bryan F

AU - Al-Khatib, Sana M

AU - Myers, J Brent

AU - Kim, Sunghee

AU - Karlsson, Lena

AU - Torp-Pedersen, Christian

AU - Wissenberg, Mads

AU - van Diepen, Sean

AU - Fosbol, Emil L

AU - Monk, Lisa

AU - Abella, Benjamin S

AU - Granger, Christopher B

AU - Jollis, James G

PY - 2013/12/17

Y1 - 2013/12/17

N2 - 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. Methods and Results-We studied 18 588 OHCAs of presumed cardiac origin in patients aged =18 years who received resuscitative efforts by emergency medical services (EMS) and were enrolled in the Cardiac Arrest Registry to Enhance Survival (CARES) from October 1, 2005, to December 31, 2010. We evaluated temporal variability in OHCA incidence and survival to hospital discharge. There was significant variability in the frequency of OHCA by hour of the day (P<0.001), day of the week (P<0.001), and month of the year (P<0.001), with the highest incidence occurring during the daytime, from Friday to Monday, in December. Survival to hospital discharge was lowest for OHCA that occurred overnight (from 11:01 pm to 7 am; 7.1%) versus daytime (7:01 am to 3 pm; 10.8%) or evening (3:01 pm to 11 pm; 11.3%; P<0.001) and during the winter (8.8%) versus spring (11.1%), summer (11.0%), or fall (10.0%; P<0.001). There was no difference in survival to hospital discharge between OHCAs that occurred on weekends and weekdays (9.5% versus 10.4%, P=0.06). After multivariable adjustment for age, sex, race, witness status, layperson resuscitation, first monitored cardiac rhythm, and emergency medical services response time, compared with daytime and spring, survival to hospital discharge remained lowest for OHCA that occurred overnight (odds ratio, 0.81; 95% confidence interval, 0.70-0.95; P=0.008) and during the winter (odds ratio, 0.81; 95% confidence interval, 0.70-0.94; P=0.006), respectively. Conclusions-There is significant temporal variability in the incidence of and survival after OHCA. The relative contribution of patient pathophysiology, likelihood of the OHCA being observed, and prehospital and hospital-based resuscitative factors deserves further exploration.

AB - 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. Methods and Results-We studied 18 588 OHCAs of presumed cardiac origin in patients aged =18 years who received resuscitative efforts by emergency medical services (EMS) and were enrolled in the Cardiac Arrest Registry to Enhance Survival (CARES) from October 1, 2005, to December 31, 2010. We evaluated temporal variability in OHCA incidence and survival to hospital discharge. There was significant variability in the frequency of OHCA by hour of the day (P<0.001), day of the week (P<0.001), and month of the year (P<0.001), with the highest incidence occurring during the daytime, from Friday to Monday, in December. Survival to hospital discharge was lowest for OHCA that occurred overnight (from 11:01 pm to 7 am; 7.1%) versus daytime (7:01 am to 3 pm; 10.8%) or evening (3:01 pm to 11 pm; 11.3%; P<0.001) and during the winter (8.8%) versus spring (11.1%), summer (11.0%), or fall (10.0%; P<0.001). There was no difference in survival to hospital discharge between OHCAs that occurred on weekends and weekdays (9.5% versus 10.4%, P=0.06). After multivariable adjustment for age, sex, race, witness status, layperson resuscitation, first monitored cardiac rhythm, and emergency medical services response time, compared with daytime and spring, survival to hospital discharge remained lowest for OHCA that occurred overnight (odds ratio, 0.81; 95% confidence interval, 0.70-0.95; P=0.008) and during the winter (odds ratio, 0.81; 95% confidence interval, 0.70-0.94; P=0.006), respectively. Conclusions-There is significant temporal variability in the incidence of and survival after OHCA. The relative contribution of patient pathophysiology, likelihood of the OHCA being observed, and prehospital and hospital-based resuscitative factors deserves further exploration.

U2 - 10.1161/circulationaha.113.004164

DO - 10.1161/circulationaha.113.004164

M3 - Journal article

C2 - 24045044

SN - 0009-7322

VL - 128

SP - 2595

EP - 2602

JO - Circulation

JF - Circulation

IS - 24

ER -

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

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