Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study

Yosuke Matsumura, Taka aki Nakada, Koichiro Shinozaki, Takashi Tagami, Tomohisa Nomura, Yoshio Tahara, Atsushi Sakurai, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura, Tagami Takashi, Dai Miyazaki, Tomoko Ogasawara, Kei Hayashida, Masaru Suzuki, Mari Amino, Nobuya Kitamura, Naoki Shimizu, Akiko AkashiSadaki Inokuchi, Yoshihiro Masui, Kunihisa Miura, Haruhiko Tsutsumi, Kiyotsugu Takuma, Ishihara Atsushi, Minoru Nakano, Hiroshi Tanaka, Keiichi Ikegami, Takao Arai, Shigeto Oda, Kenji Kobayashi, Takayuki Suda, Kazuyuki Ono, Ryosuke Furuya, Yuichi Koido, Fumiaki Iwase, Shigeru Kanesaka, Yasusei Okada, Kyoko Unemoto, Tomohito Sadahiro, Masayuki Iyanaga, Asaki Muraoka, Munehiro Hayashi, Shinichi Ishimatsu, Yasufumi Miyake, Hideo Yokokawa, Yasuaki Koyama, Asuka Tsuchiya, Tetsuya Kashiyama, Kiyohiro Oshima, Kazuya Kiyota, Yuichi Hamabe, Hiroyuki Yokota, Shingo Hori, Shin Inaba, Tetsuya Sakamoto, Naoshige Harada, Akio Kimura, Masayuki Kanai, Yasuhiro Otomo, Manabu Sugita, Kosaku Kinoshita, Mitsuhide Kitano, Kiyoshi Matsuda, Kotaro Tanaka, Katsunori Yoshihara, Kikuo Yoh, Junichi Suzuki, Hiroshi Toyoda, Kunihiro Mashiko, Takashi Muguruma, Tadanaga Shimada, Yoshiro Kobe, Tomohisa Shoko, Kazuya Nakanishi, Takashi Shiga, Takefumi Yamamoto, Kazuhiko Sekine, Shinichi Izuka

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34-2.07; P <0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93-0.96; bystander CPR: OR 0.85 and 95 % CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.

Original languageEnglish
Article number141
JournalCritical Care
Volume20
Issue number1
DOIs
Publication statusPublished - 2016 May 10

Fingerprint

Out-of-Hospital Cardiac Arrest
Resuscitation
Observational Studies
Prospective Studies
Survival
Odds Ratio
Confidence Intervals
Blood Gas Analysis
Cardiopulmonary Resuscitation
Intubation
Health Personnel
Hospital Personnel
Emergency Medical Services
Survivors
Japan

Keywords

  • Cardiopulmonary resuscitation
  • Circadian rhythm
  • Heart arrest
  • Out-of-hospital cardiac arrest
  • Resuscitation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests : A prospective observational study. / Matsumura, Yosuke; Nakada, Taka aki; Shinozaki, Koichiro; Tagami, Takashi; Nomura, Tomohisa; Tahara, Yoshio; Sakurai, Atsushi; Yonemoto, Naohiro; Nagao, Ken; Yaguchi, Arino; Morimura, Naoto; Takashi, Tagami; Miyazaki, Dai; Ogasawara, Tomoko; Hayashida, Kei; Suzuki, Masaru; Amino, Mari; Kitamura, Nobuya; Shimizu, Naoki; Akashi, Akiko; Inokuchi, Sadaki; Masui, Yoshihiro; Miura, Kunihisa; Tsutsumi, Haruhiko; Takuma, Kiyotsugu; Atsushi, Ishihara; Nakano, Minoru; Tanaka, Hiroshi; Ikegami, Keiichi; Arai, Takao; Oda, Shigeto; Kobayashi, Kenji; Suda, Takayuki; Ono, Kazuyuki; Furuya, Ryosuke; Koido, Yuichi; Iwase, Fumiaki; Kanesaka, Shigeru; Okada, Yasusei; Unemoto, Kyoko; Sadahiro, Tomohito; Iyanaga, Masayuki; Muraoka, Asaki; Hayashi, Munehiro; Ishimatsu, Shinichi; Miyake, Yasufumi; Yokokawa, Hideo; Koyama, Yasuaki; Tsuchiya, Asuka; Kashiyama, Tetsuya; Oshima, Kiyohiro; Kiyota, Kazuya; Hamabe, Yuichi; Yokota, Hiroyuki; Hori, Shingo; Inaba, Shin; Sakamoto, Tetsuya; Harada, Naoshige; Kimura, Akio; Kanai, Masayuki; Otomo, Yasuhiro; Sugita, Manabu; Kinoshita, Kosaku; Kitano, Mitsuhide; Matsuda, Kiyoshi; Tanaka, Kotaro; Yoshihara, Katsunori; Yoh, Kikuo; Suzuki, Junichi; Toyoda, Hiroshi; Mashiko, Kunihiro; Muguruma, Takashi; Shimada, Tadanaga; Kobe, Yoshiro; Shoko, Tomohisa; Nakanishi, Kazuya; Shiga, Takashi; Yamamoto, Takefumi; Sekine, Kazuhiko; Izuka, Shinichi.

In: Critical Care, Vol. 20, No. 1, 141, 10.05.2016.

Research output: Contribution to journalArticle

Matsumura, Y, Nakada, TA, Shinozaki, K, Tagami, T, Nomura, T, Tahara, Y, Sakurai, A, Yonemoto, N, Nagao, K, Yaguchi, A, Morimura, N, Takashi, T, Miyazaki, D, Ogasawara, T, Hayashida, K, Suzuki, M, Amino, M, Kitamura, N, Shimizu, N, Akashi, A, Inokuchi, S, Masui, Y, Miura, K, Tsutsumi, H, Takuma, K, Atsushi, I, Nakano, M, Tanaka, H, Ikegami, K, Arai, T, Oda, S, Kobayashi, K, Suda, T, Ono, K, Furuya, R, Koido, Y, Iwase, F, Kanesaka, S, Okada, Y, Unemoto, K, Sadahiro, T, Iyanaga, M, Muraoka, A, Hayashi, M, Ishimatsu, S, Miyake, Y, Yokokawa, H, Koyama, Y, Tsuchiya, A, Kashiyama, T, Oshima, K, Kiyota, K, Hamabe, Y, Yokota, H, Hori, S, Inaba, S, Sakamoto, T, Harada, N, Kimura, A, Kanai, M, Otomo, Y, Sugita, M, Kinoshita, K, Kitano, M, Matsuda, K, Tanaka, K, Yoshihara, K, Yoh, K, Suzuki, J, Toyoda, H, Mashiko, K, Muguruma, T, Shimada, T, Kobe, Y, Shoko, T, Nakanishi, K, Shiga, T, Yamamoto, T, Sekine, K & Izuka, S 2016, 'Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study', Critical Care, vol. 20, no. 1, 141. https://doi.org/10.1186/s13054-016-1323-4
Matsumura, Yosuke ; Nakada, Taka aki ; Shinozaki, Koichiro ; Tagami, Takashi ; Nomura, Tomohisa ; Tahara, Yoshio ; Sakurai, Atsushi ; Yonemoto, Naohiro ; Nagao, Ken ; Yaguchi, Arino ; Morimura, Naoto ; Takashi, Tagami ; Miyazaki, Dai ; Ogasawara, Tomoko ; Hayashida, Kei ; Suzuki, Masaru ; Amino, Mari ; Kitamura, Nobuya ; Shimizu, Naoki ; Akashi, Akiko ; Inokuchi, Sadaki ; Masui, Yoshihiro ; Miura, Kunihisa ; Tsutsumi, Haruhiko ; Takuma, Kiyotsugu ; Atsushi, Ishihara ; Nakano, Minoru ; Tanaka, Hiroshi ; Ikegami, Keiichi ; Arai, Takao ; Oda, Shigeto ; Kobayashi, Kenji ; Suda, Takayuki ; Ono, Kazuyuki ; Furuya, Ryosuke ; Koido, Yuichi ; Iwase, Fumiaki ; Kanesaka, Shigeru ; Okada, Yasusei ; Unemoto, Kyoko ; Sadahiro, Tomohito ; Iyanaga, Masayuki ; Muraoka, Asaki ; Hayashi, Munehiro ; Ishimatsu, Shinichi ; Miyake, Yasufumi ; Yokokawa, Hideo ; Koyama, Yasuaki ; Tsuchiya, Asuka ; Kashiyama, Tetsuya ; Oshima, Kiyohiro ; Kiyota, Kazuya ; Hamabe, Yuichi ; Yokota, Hiroyuki ; Hori, Shingo ; Inaba, Shin ; Sakamoto, Tetsuya ; Harada, Naoshige ; Kimura, Akio ; Kanai, Masayuki ; Otomo, Yasuhiro ; Sugita, Manabu ; Kinoshita, Kosaku ; Kitano, Mitsuhide ; Matsuda, Kiyoshi ; Tanaka, Kotaro ; Yoshihara, Katsunori ; Yoh, Kikuo ; Suzuki, Junichi ; Toyoda, Hiroshi ; Mashiko, Kunihiro ; Muguruma, Takashi ; Shimada, Tadanaga ; Kobe, Yoshiro ; Shoko, Tomohisa ; Nakanishi, Kazuya ; Shiga, Takashi ; Yamamoto, Takefumi ; Sekine, Kazuhiko ; Izuka, Shinichi. / Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests : A prospective observational study. In: Critical Care. 2016 ; Vol. 20, No. 1.
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abstract = "Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 {\%} confidence interval (CI), 1.34-2.07; P <0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 {\%} CI 0.93-0.96; bystander CPR: OR 0.85 and 95 {\%} CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 {\%} CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 {\%} CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.",
keywords = "Cardiopulmonary resuscitation, Circadian rhythm, Heart arrest, Out-of-hospital cardiac arrest, Resuscitation",
author = "Yosuke Matsumura and Nakada, {Taka aki} and Koichiro Shinozaki and Takashi Tagami and Tomohisa Nomura and Yoshio Tahara and Atsushi Sakurai and Naohiro Yonemoto and Ken Nagao and Arino Yaguchi and Naoto Morimura and Tagami Takashi and Dai Miyazaki and Tomoko Ogasawara and Kei Hayashida and Masaru Suzuki and Mari Amino and Nobuya Kitamura and Naoki Shimizu and Akiko Akashi and Sadaki Inokuchi and Yoshihiro Masui and Kunihisa Miura and Haruhiko Tsutsumi and Kiyotsugu Takuma and Ishihara Atsushi and Minoru Nakano and Hiroshi Tanaka and Keiichi Ikegami and Takao Arai and Shigeto Oda and Kenji Kobayashi and Takayuki Suda and Kazuyuki Ono and Ryosuke Furuya and Yuichi Koido and Fumiaki Iwase and Shigeru Kanesaka and Yasusei Okada and Kyoko Unemoto and Tomohito Sadahiro and Masayuki Iyanaga and Asaki Muraoka and Munehiro Hayashi and Shinichi Ishimatsu and Yasufumi Miyake and Hideo Yokokawa and Yasuaki Koyama and Asuka Tsuchiya and Tetsuya Kashiyama and Kiyohiro Oshima and Kazuya Kiyota and Yuichi Hamabe and Hiroyuki Yokota and Shingo Hori and Shin Inaba and Tetsuya Sakamoto and Naoshige Harada and Akio Kimura and Masayuki Kanai and Yasuhiro Otomo and Manabu Sugita and Kosaku Kinoshita and Mitsuhide Kitano and Kiyoshi Matsuda and Kotaro Tanaka and Katsunori Yoshihara and Kikuo Yoh and Junichi Suzuki and Hiroshi Toyoda and Kunihiro Mashiko and Takashi Muguruma and Tadanaga Shimada and Yoshiro Kobe and Tomohisa Shoko and Kazuya Nakanishi and Takashi Shiga and Takefumi Yamamoto and Kazuhiko Sekine and Shinichi Izuka",
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TY - JOUR

T1 - Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests

T2 - A prospective observational study

AU - Matsumura, Yosuke

AU - Nakada, Taka aki

AU - Shinozaki, Koichiro

AU - Tagami, Takashi

AU - Nomura, Tomohisa

AU - Tahara, Yoshio

AU - Sakurai, Atsushi

AU - Yonemoto, Naohiro

AU - Nagao, Ken

AU - Yaguchi, Arino

AU - Morimura, Naoto

AU - Takashi, Tagami

AU - Miyazaki, Dai

AU - Ogasawara, Tomoko

AU - Hayashida, Kei

AU - Suzuki, Masaru

AU - Amino, Mari

AU - Kitamura, Nobuya

AU - Shimizu, Naoki

AU - Akashi, Akiko

AU - Inokuchi, Sadaki

AU - Masui, Yoshihiro

AU - Miura, Kunihisa

AU - Tsutsumi, Haruhiko

AU - Takuma, Kiyotsugu

AU - Atsushi, Ishihara

AU - Nakano, Minoru

AU - Tanaka, Hiroshi

AU - Ikegami, Keiichi

AU - Arai, Takao

AU - Oda, Shigeto

AU - Kobayashi, Kenji

AU - Suda, Takayuki

AU - Ono, Kazuyuki

AU - Furuya, Ryosuke

AU - Koido, Yuichi

AU - Iwase, Fumiaki

AU - Kanesaka, Shigeru

AU - Okada, Yasusei

AU - Unemoto, Kyoko

AU - Sadahiro, Tomohito

AU - Iyanaga, Masayuki

AU - Muraoka, Asaki

AU - Hayashi, Munehiro

AU - Ishimatsu, Shinichi

AU - Miyake, Yasufumi

AU - Yokokawa, Hideo

AU - Koyama, Yasuaki

AU - Tsuchiya, Asuka

AU - Kashiyama, Tetsuya

AU - Oshima, Kiyohiro

AU - Kiyota, Kazuya

AU - Hamabe, Yuichi

AU - Yokota, Hiroyuki

AU - Hori, Shingo

AU - Inaba, Shin

AU - Sakamoto, Tetsuya

AU - Harada, Naoshige

AU - Kimura, Akio

AU - Kanai, Masayuki

AU - Otomo, Yasuhiro

AU - Sugita, Manabu

AU - Kinoshita, Kosaku

AU - Kitano, Mitsuhide

AU - Matsuda, Kiyoshi

AU - Tanaka, Kotaro

AU - Yoshihara, Katsunori

AU - Yoh, Kikuo

AU - Suzuki, Junichi

AU - Toyoda, Hiroshi

AU - Mashiko, Kunihiro

AU - Muguruma, Takashi

AU - Shimada, Tadanaga

AU - Kobe, Yoshiro

AU - Shoko, Tomohisa

AU - Nakanishi, Kazuya

AU - Shiga, Takashi

AU - Yamamoto, Takefumi

AU - Sekine, Kazuhiko

AU - Izuka, Shinichi

PY - 2016/5/10

Y1 - 2016/5/10

N2 - Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34-2.07; P <0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93-0.96; bystander CPR: OR 0.85 and 95 % CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.

AB - Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34-2.07; P <0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93-0.96; bystander CPR: OR 0.85 and 95 % CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.

KW - Cardiopulmonary resuscitation

KW - Circadian rhythm

KW - Heart arrest

KW - Out-of-hospital cardiac arrest

KW - Resuscitation

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