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Temporal differences in out-of-hospital cardiac arrest incidence and survival.

Publication ,  Journal Article
Bagai, A; McNally, BF; Al-Khatib, SM; Myers, JB; Kim, S; Karlsson, L; Torp-Pedersen, C; Wissenberg, M; van Diepen, S; Fosbol, EL; Monk, L ...
Published in: Circulation
December 17, 2013

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.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 17, 2013

Volume

128

Issue

24

Start / End Page

2595 / 2602

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Seasons
  • Retrospective Studies
  • Registries
  • Out-of-Hospital Cardiac Arrest
  • Middle Aged
  • Male
  • Incidence
 

Citation

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Bagai, A., McNally, B. F., Al-Khatib, S. M., Myers, J. B., Kim, S., Karlsson, L., … 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
Bagai, Akshay, Bryan F. McNally, Sana M. Al-Khatib, J Brent Myers, Sunghee Kim, Lena Karlsson, Christian Torp-Pedersen, et al. “Temporal differences in out-of-hospital cardiac arrest incidence and survival.Circulation 128, no. 24 (December 17, 2013): 2595–2602. https://doi.org/10.1161/CIRCULATIONAHA.113.004164.
Bagai A, McNally BF, Al-Khatib SM, Myers JB, Kim S, Karlsson L, et al. Temporal differences in out-of-hospital cardiac arrest incidence and survival. Circulation. 2013 Dec 17;128(24):2595–602.
Bagai, Akshay, et al. “Temporal differences in out-of-hospital cardiac arrest incidence and survival.Circulation, vol. 128, no. 24, Dec. 2013, pp. 2595–602. Pubmed, doi:10.1161/CIRCULATIONAHA.113.004164.
Bagai A, McNally BF, Al-Khatib SM, Myers JB, Kim S, Karlsson L, Torp-Pedersen C, Wissenberg M, van Diepen S, Fosbol EL, Monk L, Abella BS, Granger CB, Jollis JG. Temporal differences in out-of-hospital cardiac arrest incidence and survival. Circulation. 2013 Dec 17;128(24):2595–2602.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

December 17, 2013

Volume

128

Issue

24

Start / End Page

2595 / 2602

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Seasons
  • Retrospective Studies
  • Registries
  • Out-of-Hospital Cardiac Arrest
  • Middle Aged
  • Male
  • Incidence