Are Hospital Patients Less Likely to Survive Cardiac Arrest After Hours?

Did you know hospital patients who experience a cardiac arrest might “be more likely to die if it happens in the middle of the night or on a weekend than if it occurs on a weekday” during regular business hours? That’s what one U.S. study is suggesting. After examining data on “more than 151,000 adults who had a cardiac arrest at 470 U.S. hospitals between 2000 and 2014,” researchers determined that cardiac arrest patients had a better chance of living if the potentially fatal medical emergency occurs during the day, Monday through Friday.

Did you know hospital patients who experience a cardiac arrest might “be more likely to die if it happens in the middle of the night or on a weekend than if it occurs on a weekday” during regular business hours? That’s what one U.S. study is suggesting. After examining data on “more than 151,000 adults who had a cardiac arrest at 470 U.S. hospitals between 2000 and 2014,” researchers determined that cardiac arrest patients had a better chance of living if the potentially fatal medical emergency occurs during the day, Monday through Friday.

According to the study, individuals who had a cardiac arrest during the weekends or between 11 p.m. And 7 a.m. during the week only have an estimated survival rate of 22 percent. Patients who “experienced a cardiac arrest during weekday ‘on-hours’ from 7 a.m. to 11 p.m. fared better,” with survival odds of about 25 percent.

Of the more than 151,000 adults the study examined, about 52% or 79,000 experienced a cardiac arrest “during off-hours in the hospital,” while the remaining individuals had one during on-hours. The study also found that 94,000 patients who had a cardiac arrest “survived the initial resuscitation efforts that happened right after they went into cardiac arrest.” However, only 28,000 patients “survived until they could be sent home from the hospital.” To break it down further, 21% of the “on-hours cardiac arrest patients survived until discharge” while only “17% of the patients who had an off-hours cardiac arrest” survived until discharge.

So why is there such a difference between the two groups? Well, the study mentions that patients who experience an off-hours cardiac arrest “might be sicker than other people in ways that weren’t measured in the study.” Additionally, the research team behind the study “lacked data on physician and nurse staffing levels.”

Dr. Julia Indik, author of an accompanying editorial and a professor at the Sarver Heart Center at the University of Arizona in Tucson agreed with this, saying:

“The availability of advanced forms of care varies by time of day. Certain types of procedures that can be life-saving require highly trained sub-specialists and highly trained teams that are not on the premises of a hospital 24-7.”

When commenting on the results of the recent study, Dr. Uchenna Ofoma of Temple University and Geisinger Health System, as well as the lead author of the study, said:

“Survival to hospital discharge has improved over time in both groups of patients, on-hours, and off-hours. However, the persistent survival disparities between on-hours and off-hours arrest remain concerning…It’s unclear why this is happening, or to what extent it might be due to reduced staffing, less availability of specialists or fewer people around to notice and respond to problems during the off-hours…This is the million-dollar question. Survival from in-hospital cardiac arrest is integrally dependent on early recognition and prompt initiation of high-quality resuscitation, coupled with high-quality post-resuscitation care for those who survive initial resuscitation.”

But what is a cardiac arrest? How dangerous is it? For starters, it “involves the abrupt loss of heart function, breathing, and consciousness.” It differs from a heart attack, which occurs “when blood flow to a portion of the heart is blocked,” because cardiac arrest “occurs when the heart’s electrical system malfunctions, often due to irregular heart rhythms.” Unfortunately, cardiac arrests often prove fatal, though have a much better chance of not being fatal if they occur in a hospital setting.

Sources:

Hospital patients less likely to survive ‘off-hours’ cardiac arrest

Patients less likely to survive in-hospital cardiac arrest on nights, weekends