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

19 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

Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Matsumura, Y., Nakada, T. A., 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., ... Izuka, S. (2016). Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study. Critical Care, 20(1), [141]. https://doi.org/10.1186/s13054-016-1323-4