Effect of time and day of admission on 1-month survival and neurologically favourable 1-month survival in out-of-hospital cardiopulmonary arrest patients.

Abstract

We sought to examine whether the outcomes of out-of-hospital cardiopulmonary arrest (OHCA) patients differed between weekday and weekend/holiday admissions, or between daytime and nighttime admissions. From a national registry of OHCA events in Japan between 2005 and 2008, 173,137 cases where the call-to-hospital admission interval was shorter than 120 min and collapse was witnessed by a bystander were included in this study. One-month survival rate and neurologically favourable 1-month survival rate were used as outcome measures. Logistic regression was used to adjust for potential confounding factors. No significant differences in outcome were found between weekday and holiday/weekend admissions in rates of 1-month survival or neurologically favourable 1-month survival (p=0.78 and p=0.80, respectively). In contrast, patients admitted in the daytime exhibited significantly better outcomes than those admitted at night, on both outcome measures (p<0.001 and p<0.001). After adjusting for possible confounding factors, outcomes were significantly better for daytime admissions, with odds ratios of 1.26 (95% confidence interval (CI) 1.22-1.31; p<0.001) for 1-month survival, and 1.26 (95% CI 1.20-1.32; p<0.001) for neurologically favourable 1-month survival. In contrast, no significant differences on either outcome measure were found between weekday and weekend/holiday cases, with odds ratios of 1.00 (95% CI 0.96-1.04; p=0.96) for 1-month survival and 0.99 (95% CI 0.94-1.04; p=0.78) for neurologically favourable 1-month survival. Even after adjusting for confounding factors, admission day (weekday vs. weekend/holiday) had no effect on 1-month survival or neurologically favourable 1-month survival. In contrast, daytime admission was associated with significantly better outcomes than nighttime admissions.