Study: Patients experiencing cardiac arrest less likely to survive 'off-hours'

Hospital patients who experience cardiac arrest in a hospital during nights or weekends may have a lower chance of survival than patients who experience cardiac arrest during a weekday, according to a new study published in the Journal of the American College of Cardiology.

For the study, a team of researchers — led by Uchenna Ofoma, MD, attending physician with the division of critical care medicine at Danville, Pa.-based Geisinger — analyzed the data of 151,071 patients who experienced in-hospital cardiac arrest between January 2000 and December 2014.

"On-hours" was described as 7:00 a.m. to 10:59 p.m. Monday to Friday. "Off-hours" was categorized as 11:00 p.m. to 6:59 a.m. Monday to Friday or anytime during the weekend.

Here are four findings from the study.

1. Overall, survival to discharge in patients who experienced cardiac arrest during off-hours was 3.8 percent lower than patients who experienced cardiac arrest during on-hours.

2. More than half — 52 percent — of patients in the study experienced cardiac arrest during off-hours. All together, 62.4 percent of patients survived acute resuscitation efforts and 18.6 percent survived to discharge.

3. Over the 15-year study period, survival odds for cardiac arrest patients during off-hours improved from 12 percent at the start of the study to about 22 percent by the end of the study. On weekday hours, the survival odds for patients experiencing cardiac arrest rose from 16 percent to 25 percent by the end of the study.

"While it was encouraging to see that survival has increased in both groups of patients, the persistent survival disparities between on-hours and off-hours remains disheartening," Dr. Ofoma said. "Timing of in-hospital cardiac arrest has a major impact on a patient's outcome, so we must make this an area to focus quality improvement efforts to ensure that improved survival trends are sustained over time."

4. Researchers cited several reasons for the survival rate disparities, which included changes to hospital staffing patterns during nights and weekends, nurse-to-patient ratios during off-hours and the impact of working the night-shift on psychomotor skills.

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