Effect of time and day of admission on 1-month survival and neurologically favourable 1-month survival in out-of-hospital cardiopulmonary arrest patients
Effect of time and day of admission on 1-month survival and neurologically favourable 1-month survival in out-of-hospital cardiopulmonary arrest patients
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DOI：
10.1016/j.resuscitation.2011.02.007
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发表时间：
2011-07-01
期刊：
影响因子：
6.5
通讯作者：
Imamura, Tomoaki
中科院分区：
文献类型：
--
作者：
Koike, Soichi;Tanabe, Seizan;Imamura, Tomoaki
目的：我们试图检查院外心肺骤停（OHCA）患者的结果在工作日和周末/假期入院之间或白天和夜间入院之间是否存在差异。方法：从2005年至2008年日本OHCA事件的国家登记处来看，173，本研究纳入了137例患者，这些患者的呼叫入院间隔时间短于120 min，并且旁观者目睹了崩溃。1个月生存率和神经学良好的1个月生存率被用作结局指标。Logistic回归被用来调整潜在的混杂factors.Results：没有显着差异的结果被发现之间的工作日和假期/周末入院率1个月的生存率或神经学有利的1个月生存（p = 0.78和p = 0.80，分别）。相比之下，白天入院的患者在两个结局指标上都表现出明显优于夜间入院的患者（p < 0.001和p < 0.001）。在调整可能的混杂因素后，日间入院的预后明显更好，1个月生存率的比值比为1.26（95%置信区间（CI）1.22-1.31; p < 0.001），神经学上有利的1个月生存率的比值比为1.26（95% CI 1.20-1.32; p < 0.001）。相比之下，在工作日和周末/假日病例之间，两种结局指标均无显著差异，比值比为1.00（95% CI 0.96-1.04; p = 0.96）1个月生存期和0.99（95% CI 0.94-1.04; p = 0.78）的神经学上有利的1个月生存率。即使在调整混杂因素后，入院日（工作日vs.周末/假期）对1个月生存率或神经学上有利的1个月生存率没有影响。相比之下，白天入院与夜间入院相比，预后明显更好。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Aim: We sought to examine whether the outcomes of out-of-hospital cardiopulmonary arrest (OHCA) patients differed between weekday and weekend/holiday admissions, or between daytime and nighttime admissions.Methods: From a national registry of OHCA events in Japan between 2005 and 2008, 173,137 cases where the call-to-hospital admission interval was shorter than 120 min and collapse was witnessed by a bystander were included in this study. One-month survival rate and neurologically favourable 1-month survival rate were used as outcome measures. Logistic regression was used to adjust for potential confounding factors.Results: No significant differences in outcome were found between weekday and holiday/weekend admissions in rates of 1-month survival or neurologically favourable 1-month survival (p = 0.78 and p = 0.80, respectively). In contrast, patients admitted in the daytime exhibited significantly better outcomes than those admitted at night, on both outcome measures (p < 0.001 and p < 0.001). After adjusting for possible confounding factors, outcomes were significantly better for daytime admissions, with odds ratios of 1.26 (95% confidence interval (CI) 1.22-1.31; p < 0.001) for 1-month survival, and 1.26 (95% CI 1.20-1.32; p < 0.001) for neurologically favourable 1-month survival. In contrast, no significant differences on either outcome measure were found between weekday and weekend/holiday cases, with odds ratios of 1.00 (95% CI 0.96-1.04; p = 0.96) for 1-month survival and 0.99 (95% CI 0.94-1.04; p = 0.78) for neurologically favourable 1-month survival.Conclusions: Even after adjusting for confounding factors, admission day (weekday vs. weekend/holiday) had no effect on 1-month survival or neurologically favourable 1-month survival. In contrast, daytime admission was associated with significantly better outcomes than nighttime admissions. (C) 2011 Elsevier Ireland Ltd. All rights reserved.