Abstract 13260: Trends in Survival From In-hospital Cardiac Arrests During Nights and Weekends
Background: In-hospital cardiac arrest (IHCA) survival is worse during nights and weekends. Although survival and neurologic outcomes after IHCA have improved in recent years, it remains unknown whether the above trends are consistent in patients with IHCA during nights and weekends.
Methods: We identified 151,071 adults at 470 U.S. hospitals in the Get with the Guidelines-Resuscitation registry during 2000-2014. Using multivariable logistic regression with generalized estimating equations, we examined temporal trends in survival to discharge and determined whether trends in IHCA differed during on-hours (Monday - Friday 7:00 am - 10:59 pm) vs. off-hours (Monday - Friday 11:00 pm - 6:59 am, Saturday-Sunday, all day). We also examined acute resuscitation and post-resuscitation survival as secondary outcomes.
Results: Among 151,071 participants, 79,091 (52.4%) had an IHCA during off-hours. Risk-adjusted survival proportions improved over time in both groups (on-hours: 16.0% in 2000, 25.2% in 2014; off-hours: 11.9% in 2000, 21.9% in 2014; P for trend < .001 for both). However, temporal trends in survival did not differ between on-hours and off-hours both on absolute (P=0.75) and relative scale (P = .059, Table). Acute resuscitation survival improved significantly in both groups (on-hours: 56.1% in 2000, 71% in 2014; off-hours: 46.9% in 2000, 68.2% in 2014; P for trend < .001 for both) such that difference between on-hours and off-hours narrowed over time (P=0.02 absolute scale, P < .001 relative scale, Table). In contrast, although post-resuscitation survival improved over time in both groups (P for trend < .001), the absolute and relative differences persisted in both groups (Table).
Conclusions: Despite a significant temporal reduction in acute resuscitation survival difference for IHCA during on-hours compared to off-hours, differences in overall survival persist between the groups, highlighting an important area for quality improvement.
Author Disclosures: U.R. Ofoma: None. S. Basnet: None. A. Berger: None. H.L. Kirchner: None. S. Girotra: Research Grant; Significant; NHLBI.
- © 2016 by American Heart Association, Inc.