Trends in Survival After In-Hospital Cardiac Arrest During Nights and Weekends.
Trends in Survival After In-Hospital Cardiac Arrest During Nights and Weekends.
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DOI：
10.1016/j.jacc.2017.11.043
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发表时间：
2018-01-30
影响因子：
24
通讯作者：
American Heart Association Get With the Guidelines – Resuscitation Investigators
中科院分区：
文献类型：
--
作者：
Ofoma UR;Basnet S;Berger A;Kirchner HL;Girotra S;American Heart Association Get With the Guidelines – Resuscitation Investigators
住院心脏骤停（IHCA）后的生存率在夜间和周末（非工作时间）低于工作日白天（工作时间）。由于整体IHCA生存率随着时间的推移而提高，因此仍不清楚工作时间和非工作时间之间的生存差异是否发生了变化。检查工作时间和非工作时间IHCA之间生存差异的时间趋势。我们在2000年至2014年期间在470家美国医院的指南复苏登记处确定了151，071名成年人。使用广义估计方程的多变量逻辑回归，我们检查了IHCA的生存趋势在工作时间（周一至周五上午7：00-下午10：59）是否不同。与非工作时间（星期一至星期五晚上11：00至上午6：59，星期六-星期日，全天）。在151，071名参与者中，79，091人（52.4%）在下班时间进行了IHCA。两组的风险调整生存率均随时间推移而改善（工作时间：2000年为16.0%，2014年为25.2%;非工作时间：2000年为11.9%，2014年为21.9%;两组的趋势P <0.001）。然而，无论是在绝对（P=0.75）还是相对量表（P=0.059）上，工作时间和非工作时间之间的生存差异随时间推移均无显著变化。两组的急性复苏存活率均显著提高（工作时间：2000年为56.1%，2014年为71%;非工作时间：2000年为46.9%，2014年为68.2%;两组的趋势P <.001），工作时间和非工作时间之间的差异随时间推移而缩小（P = 0.02绝对量表，P<.001相对量表）。相反，尽管两组的复苏后生存率也随着时间的推移而改善（两组的趋势P <0.001），但绝对和相对差异仍然存在。尽管生存率总体上有所改善，但与工作时间相比，IHCA在非工作时间的生存率较低。
Survival after in-hospital cardiac arrest (IHCA) is lower during nights and weekends (off-hours) compared to daytime during weekdays (on-hours). As overall IHCA survival has improved over time, it remains unknown whether survival differences between on-hours and off-hours have changed. To examine temporal trends in survival differences between on-hours and off-hours IHCA. 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 whether survival trends in IHCA differed during on-hours (Monday–Friday 7:00 a.m.–10:59 p.m.) vs. off-hours (Monday–Friday 11:00 p.m.–6:59 a.m., and Saturday-Sunday, all day). Among 151,071 participants, 79,091 (52.4%) had an IHCA during off-hours. Risk-adjusted survival 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 there was no significant change in the survival difference over time between on-hours and off-hours, either on an absolute (P=0.75) or a relative scale (P=0.059). 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) and the difference between on-hours and off-hours narrowed over time (P = 0.02 absolute scale, P<.001 relative scale). In contrast, although post-resuscitation survival also improved over time in both groups (P for trend <.001 for both), the absolute and relative difference persisted. Despite an overall improvement in survival, lower survival in IHCA during off-hours compared to on-hours persist.
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影响因子：
15.8
作者：
Barger LK;Ayas NT;Cade BE;Cronin JW;Rosner B;Speizer FE;Czeisler CA
通讯作者：
Czeisler CA
影响因子：
37.8
作者：
Peckova, M;Fahrenbruch, CE;Hallstrom, AP
通讯作者：
Hallstrom, AP
影响因子：
120.7
作者：
Nadkarni, VM;Larkin, GL;Berg, RA
通讯作者：
Berg, RA
影响因子：
26.1
作者：
Bhanji F;Topjian AA;Nadkarni VM;Praestgaard AH;Hunt EA;Cheng A;Meaney PA;Berg RA;American Heart Association’s Get With the Guidelines–Resuscitation Investigators
通讯作者：
American Heart Association’s Get With the Guidelines–Resuscitation Investigators
影响因子：
37.8
作者：
ARNTZ, HR;WILLICH, SN;SCHRODER, R
通讯作者：
SCHRODER, R