Out-of-hospital cardiac arrest frequency and survival: Evidence for temporal variability

RESUSCITATION

卷:81

Article

Brooks, Steven C.^1,2  Schmicker, Robert H.³  Rea, Thomas D.⁴  Aufderheide, Tom P.⁵  Davis, Daniel P.⁶  Morrison, Laurie J.¹  Sahni, Ritu⁷  Sears, Gena K.³  Griffiths, Denise E.⁷  Sopko, George⁸  Emerson, Scott S.³  Dorian, Paul⁹ 

[1] Univ Toronto, St Michaels Hosp, Keenan Res Ctr,Dept Med, Li Ka Shing Knowledge Inst,Div Emergency Med, Toronto, ON M5B 1M8, Canada

[2] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Emergency Serv, Div Emergency Med,Dept Med, Toronto, ON M5B 1M8, Canada

[3] Univ Washington, Clin Trials Ctr, Seattle, WA 98195 USA

[4] Univ Washington, Div Gen Med, Seattle, WA 98195 USA

[5] Med Coll Wisconsin, Dept Emergency Med, Milwaukee, WI 53226 USA

[6] Univ Calif San Diego, Dept Emergency Med, San Diego, CA 92103 USA

[7] Oregon Hlth & Sci Univ, Ctr Policy & Res Emergency Med, Portland, OR 97201 USA

[8] NHLBI, Div Cardiovasc Dis, NIH, Bethesda, MD 20892 USA

[9] Univ Toronto, Dept Med, Div Cardiol, Toronto, ON M5B 1M8, Canada

关键词: Out-of-hospital cardiac arrest;    Circadian rhythm;    Temporal variation;   

DOI  :  10.1016/j.resuscitation.2009.10.021

来源: Elsevier

【 摘 要 】

Aim: Some cardiac phenomena demonstrate temporal variability. We evaluated temporal variability in out-of-hospital cardiac arrest (OHCA) frequency and outcome. Methods: Prospective cohort Study (the Resuscitation Outcomes Consortium) of all OHCA of presumed cardiac cause who were treated by emergency medical services within 9 US and Canadian sites between 12/1/2005 and 02/28/2007. In each site, Emergency Medical System records were collected and analyzed. Outcomes were individually verified by trained data abstractors. Results: There were 9667 included patients. Median age was 68 (IQR 24) years, 66.7% were male and 8.3% survived to hospital discharge. The frequency of cardiac arrest varied significantly across time blocks (p < 0.001). Compared to the 0001-0600 hourly time block, the odds ratios and 95% CIs for the Occurrence of OHCA were 2.02 (1.90, 2.15) in the 0601-1200 block, 2.01 (1.89, 2.15) in the 1201-1800 block, and 1.73 (1.62, 1.85) in the 1801-2400 block. The frequency of all OHCA varied significantly by day of week (p = 0.03) and month of year (p < 0.001) with the highest frequencies on Saturday and during December. Survival to hospital discharge was lowest when the OHCA occurred during the 0001-0600 time block (7.3%) and highest during the 1201-1800 time block (9.6%). Survival was highest for OHCAs occurring on Mondays (10.0%) and lowest for those on Wednesdays (6.8%) (p = 0.02). Conclusion:There is temporal variability in OHCA frequency and Outcome. Underlying patient, EMS system and environmental factors need to be explored to offer further insight into these observed patterns. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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