Abstract 17821: Night Time In-hospital Cardiac Arrest Impairs Good Neurological Survival in a Swiss Teaching Hospital
Introduction: Cardiac arrests (CA) occurring at night have been shown to be associated with lower survival rates for both out-of-hospital and in-hospital resuscitation. There is only scarce information available for Switzerland. We monitored “Rapid Response Team” (RRT) missions at our teaching hospital after implementation of the AHA 2010 guidelines. Survival data for in-hospital cardiac arrest (IHCA) were investigated depending whether the event occurred during the day or at night.
Methods: A standardized extended in-hospital Utstein data set of all RRT-interventions at the University Hospital Basel, Switzerland, from December 13, 2010 until March 31, 2015 was consecutively collected and recorded in Microsoft Excel (Microsoft Corp., USA). Data were analyzed using IBM SPSS Statistics 22.0 (IBM Corp., USA) and are presented as descriptive statistics.
Results: RRT was activated for 636 patients, with 459 having a life-threatening status (72%; 33 missing). 270 patients (59%) suffered IHCA. 92 CAs (34%) occurred during the night-shift (23:00 - 06:59), and 177 CAs (66%) occurred during day-shifts (07:00 - 22:59; 1 case with “time data” missing).
Shockable rhythms and witnessed CA were found more often at day- compared with night-time: 34 (20%) vs. 8 (9%; p=0.032) and 133 (77%) vs. 55 (62%; p=0.009), respectively. There was no difference between day and night regarding first-responder chest compressions before RRT arrival. Patients whose IHCA occurred during the day showed more favorable neurological outcomes (Cerebral Performance Categories (CPC) of 1+2: 47 (28%) vs. 15 (17%; p=0.048)). Return of spontaneous circulation (ROSC) and hospital discharge were not different. The time to reach the CA patient was not different (123 s for first responder, 245 s for the complete team).
Conclusions: IHCA occurring at night show a less favorable neurological outcome than during day time at a Swiss university hospital. A lower rate of shockable rhythms may be a sign of delayed recognition of CA during nighttime, which may be an explanation for the reduced CPC-score.
Author Disclosures: L. Marengo: None. W. Ummenhofer: None. P. Gerster: None. F. Harm: None. M. Lüthy: None. M. Zürcher: None.
- © 2015 by American Heart Association, Inc.