Impact of holiday periods on survival following an in-hospital cardiac arrest

Abstract

IntroductionHigher rates of mortality following an in-hospital cardiac arrest (IHCA) has been shown during nights and weekends, changes in staff density and composition has been suggested as a possible explanation. Changes in hospital staffing patterns are also common during holiday periods. AimTo investigate whether holiday periods are associated with decreased survival following an IHCA. Material and methodsAll patients ≥18 years who experienced an IHCA at Karolinska University Hospital between 2006 and 2019 were included. Patients were identified via and data was collected from the Swedish Registry for Cardiopulmonary Resuscitation. Holiday was defined as two periods, a seven-week summer period and an approximately two-week Christmas period. The primary outcome was return of spontaneous circulation (ROSC), secondary survival to hospital discharge. Logistic regression was performed to calculate odds ratio (OR) with 95% confidence intervals (CI), adjustment was done for known confounders. ResultsOut of 1936 registered cases, 264 (14%) occurred during holiday periods. Patient and event characteristics were similar on holidays compared to non-holidays. Both ratio for ROSC (45% and 55%, respectively) and survival (25% and 32% respectively) was poorer during holiday periods Adjusted OR for ROSC and survival was poorer during holiday periods compared non-holiday periods (OR 0.69 [95% CI, 0.53–0.92] and OR 0.69 [95% CI, 0.49–0.96], respectively). ConclusionOutcomes after IHCA was poorer during holiday periods compared to non-holiday periods even if patient and event characteristics was similar. Further research is needed to better understand to what degree staffing patterns and other factors contribute to the observed difference.