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Chances Of Survival Depends On What Time Cardiac Arrest Occurs
If you are in the hospital and have cardiac arrest at night or on the
weekend, you have a significantly lower chance of survival to discharge
than if you had the arrest during day or evening times on weekdays,
according to Mary Ann Peberdy of Virginia Commonwealth
University in Richmond, VA and colleagues. The results of
their study are published in The Journal of the American
Medical Association (JAMA).
The researchers suggest that patient, hospital, staffing, and response
factors could come together to reduce the effectiveness of detecting
and treating cardiac arrests at night. The findings are essential to
inform decisions regarding hospital staffing, training, care delivery
processes, and equipment - especially if in-hospital cardiac arrests
are more frequent or survival is less likely on nights and weekends.
The study data consisted of 86,748 adult, in-hospital cardiac arrest
events occurring at 507
medical/surgical hospitals from January 2000 to February 2007. All of
the hospitals participate in the American Heart
Association's National Registry of Cardiopulmonary
Resuscitation. Peberdy and colleagues evaluated survival rates
for adults with in-hospital cardiac arrest by time of day and day of
week. They examined survival from cardiac arrest using the following
definitions:
Day/evening is 7:00 a.m. to 10:59 p.m.
Night is 11:00 p.m. to 6:59 a.m.
Weekend is 11:00 p.m. on Friday to 6:59 a.m. on Monday
There were 58,593 in-hospital cardiac arrest events that occurred
during day/evening hours (15,110 on weekends) and 28,155 cases during
night hours (7,790 on weekends).
Key findings include that compared to day/evening cardiac arrest events:
Rates of survival to discharge were lower at night, 14.7%
vs. 19.8%,
Rates of return of spontaneous circulation for longer than
20 minutes were lower at night, 44.7% vs. 51.1%,
Rates of survival at 24 hours were lower at night, 28.9%
vs. 35.4%,
Rates of favorable neurological outcomes were lower at
night, 11.0% vs. 15.2%,
There was only a slight difference between survival to discharge at
night during the week (14.6%) and during weekends (14.8%). However, the
rate of survival during day/evening weekdays was higher than on
weekends (20.6% vs. 17.4%).
The researchers write, "The principal finding of this study was that
survival to discharge following in-hospital cardiac arrest was lower
[when the arrest occurred] during nights and weekends compared with
day/evening times on weekdays, even after accounting for many
potentially confounding patient, arrest event, and hospital factors.".
"The mechanism for the decreased survival during the night is likely
multifactorial, potentially including biological differences in
patients as well as health care staff and hospital staffing and
operational factors. These data suggest the need to focus on night and
weekend hospitalwide resuscitation system processes of care that can
potentially improve patient safety and survival following cardiac
arrest," conclude the authors.
Click
Here to View JAMA website
Written by: Peter M Crosta
Copyright: Start Sanatate
Not to be reproduced without permission of Start Sanatate
ªansele de supravieþuire depinde de ceea ce se produce timp stop cardiac - Chances Of Survival Depends On What Time Cardiac Arrest Occurs - articole medicale engleza - startsanatate