Abstract MP45: Monday Morning Surge of Sudden Out-of-hospital Cardiac Arrest -from 63,620 Cases of Japanese Adults Aged 20-65 -All Japan Utstein Registry Study
Circadian and weekly variation in the incidence of out-of-hospital cardiac arrest (OHCA) was observed in previous studies. However, most of them are often small, regional, and not population based. We therefore examined circadian and weekly variation in sudden cardiac arrest using 4 years of data from national database of cardiac arrest registry, the All-Japan Utstein Registry of the FDMA (Fire and Disaster Management Agency), Japanese government.
Method: From January 1, 2005, through December 31, 2008, we conducted a population-based, observational study involving consecutive patients across Japan who had an OHCA. Incidence rate ratio (IRR) of OHCA were calculated for every 3hours and day of week by Poisson regression analysis.
Results: A total of 63,620 adults aged 20-65 who had an OHCA were included in this study; the pattern in the occurrence of OHCA is characterized by a marked bimodal peak at 6-8 o’clock and 15-17 o’clock (P for <0.001)(Figure1). Interestingly, the IRR of OHCA in the Monday morning was the highest 2.16 (95%CI: 1.99-2.35) compared with the midnight in Sunday (reference). These associations were robust after adjusting for age and sex. The incidence rate of OHCA in the morning is decreasing over the day of week and the lowest in Sunday (P<0.0001). The IRR for the Sunday morning was 1.56 (95% CI, 1.44-1.72).
Conclusion: Large population based registry showed circadian and weekly variation variations in OHCA aged 20-65. The risk of cardiac arrest is highest in the morning and late afternoon. Monday morning was the highest risk and the mental stress of starting a new working week may be a cause.
- © 2013 by American Heart Association, Inc.