Abstract
Circadian pattern influence on the incidence of out-of-hospital cardiac arrest (OHCA) has been demonstrated. However, the effect of temporal difference on the clinical outcomes of OHCA remains inconclusive. Therefore, we conducted a retrospective study in an urban city of Taiwan between January 2018 and December 2020 in order to investigate the relationship between temporal differences and the return of spontaneous circulation (ROSC), sustained (≥24 h) ROSC, and survival to discharge in patients with OHCA. Of the 842 patients with OHCA, 371 occurred in the daytime, 250 in the evening, and 221 at night. During nighttime, there was a decreased incidence of OHCA, but the outcomes of OHCA were significant poor compared to the incidents during the daytime and evening. After multivariate adjustment for influencing factors, OHCAs occurring at night were independently associated with lower probabilities of achieving sustained ROSC (aOR = 0.489, 95% CI: 0.285–0.840, p = 0.009) and survival to discharge (aOR = 0.147, 95% CI: 0.03–0.714, p = 0.017). Subgroup analyses revealed significant temporal differences in male patients, older adult patients, those with longer response times (≥5 min), and witnessed OHCA. The effects of temporal difference on the outcome of OHCA may be a result of physiological factors, underlying etiology of arrest, resuscitative efforts in prehospital and in-hospital stages, or a combination of factors.
Highlights
Out-of-hospital cardiac arrest (OHCA) is a universal public health problem that claims nearly 3.7 million lives annually [1]
The results showed that there was no significant difference between achieving return of spontaneous circulation (ROSC) in OHCA that occurred at night compared to OHCA that occurred during the daytime (adjusted odds ratio = 0.74, 95% confidence interval (CI): 0.477–1.148, p = 0.18) (Table 2)
Patients living in medical institutions may have more comorbidities than those who do not live in medical institutions, which could contribute to the poor clinical outcomes of OHCA incidents at night
Summary
Out-of-hospital cardiac arrest (OHCA) is a universal public health problem that claims nearly 3.7 million lives annually [1]. Incidence and outcomes of OHCAs vary greatly around the world [2,3]. In a recent report from the International Liaison Committee on Resuscitation (ILCOR), the annual incidence of emergency medical services (EMS)-treated. OHCA in a global population ranged from 30.0 to 97.1 per 100,000 individuals. Despite the advances in the treatment of OHCA, the rate of survival to discharge or 30-day survival remains poor at 3.1–20.4% across different regions of the world [2]. Increased understanding of the variables that affect OHCA clinical outcomes is important for developing preventative strategies and optimizing care for OHCA.
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