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Diurnal variations in incidence and outcome of out-of-hospital cardiac arrest including prior comorbidity and pharmacotherapy: A nationwide study in Denmark

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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AIM: To investigate diurnal variations in incidence and outcomes following out-of-hospital cardiac arrest (OHCA).

METHODS: OHCA of presumed cardiac aetiology were identified through the nationwide Danish Cardiac Arrest Registry (2001-2010). Time of day was divided into three time periods: daytime 07.00-14.59; evening 15.00-22.59; and nighttime 23.00-06.59.

RESULTS: We identified 18,929 OHCA patients, aged ≥ 18 years. The median age was 72 years (IQR 62-80) and the majority were male (67.5%). OHCA occurrence varied across time periods, with 43.9%, 35.7% and 20.6% occurring during daytime, evening and nighttime, respectively. Nighttime patients were more likely to have: severe comorbidity (i.e. COPD), arrest in private home (87.2% vs. 69.0% and 73.0% daytime and evening, respectively), non-witnessed arrest (51.2% vs. 48.4% and 43.7%), no bystander CPR (75.9% vs. 68.4% and 66.1%), longer time interval from recognition of OHCA to rhythm analysis (12min vs. 11min and 11min), and non-shockable heart rhythm (80.1% vs. 70.3% and 69.4%), all p<0.0001. Nighttime patients were less likely to achieve return of spontaneous circulation on arrival at the hospital (7.5% vs. 14.8% and 15.1%) and 1-year survival (2.8% vs. 7.2% and 7.1%), p<0.0001. Overall, the lower 1-year survival rate persisted after adjusting for patient-related and cardiac-arrest related characteristics mentioned above (OR 0.47, 95%CI 0.37-0.59; OR 0.51, 95%CI 0.40-0.65, compared to daytime and evening, respectively).

CONCLUSIONS: We found nighttime patients to have a lower survival compared to daytime and evening that persisted when adjusting for patient-related and cardiac-arrest related characteristics including comorbidities.

OriginalsprogEngelsk
TidsskriftResuscitation
Vol/bind85
Udgave nummer9
Sider (fra-til)1161-1168
ISSN0300-9572
DOI
StatusUdgivet - 24 jun. 2014

ID: 44378884