J P Pell1, J Sirel, A K Marsden, S M Cobbe. 1. Department of Public Health Medicine, Greater Glasgow Health Board, Dalian House, 350 St Vincents Street, Glasgow G3 8YU, UK. jill.pell@glasgow-hb.scot.nhs.uk
Abstract
OBJECTIVE: To determine whether there are seasonal variations in survival following out of hospital cardiopulmonary arrest. DESIGN: Prospective cohort study using the Heartstart (Scotland) database. SETTING: All of Scotland. PATIENTS: 10 890 people who suffered out of hospital cardiopulmonary arrest in the summer or winter between December 1988 and August 1997 inclusive. INTERVENTION: Univariate comparisons of 5406 arrests occurring in summer with 5484 in winter, in terms of patient characteristics, management, and survival using chi(2) and Mann-Whitney U tests. Multivariate analysis of the association between season and survival following adjustment for case mix. MAIN OUTCOMES MEASURES: Survival to discharge from hospital, survival pre-admission, in-hospital survival. RESULTS: Only 6% of people who arrested in winter survived to discharge, compared to 8% of those who arrested in summer (odds ratio 0.77, p < 0.001). People who arrested in winter had a poorer risk profile in that they were older, more likely to arrest at home, less likely to have a witness, and less likely to receive defibrillation. However, after adjustment for case mix, people who arrested in winter were still 19% less likely to survive compared to those who arrested in summer. Deaths pre-admission were significantly higher in winter (odds ratio 1.18, p < 0.05) but in-hospital deaths were not. CONCLUSIONS: People who suffer cardiopulmonary arrest in winter have a significantly lower likelihood of surviving. This is, in part, caused by the higher frequency of a number of recognised risk factors. However, their prognosis remains poorer even after adjustment for these factors.
OBJECTIVE: To determine whether there are seasonal variations in survival following out of hospital cardiopulmonary arrest. DESIGN: Prospective cohort study using the Heartstart (Scotland) database. SETTING: All of Scotland. PATIENTS: 10 890 people who suffered out of hospital cardiopulmonary arrest in the summer or winter between December 1988 and August 1997 inclusive. INTERVENTION: Univariate comparisons of 5406 arrests occurring in summer with 5484 in winter, in terms of patient characteristics, management, and survival using chi(2) and Mann-Whitney U tests. Multivariate analysis of the association between season and survival following adjustment for case mix. MAIN OUTCOMES MEASURES: Survival to discharge from hospital, survival pre-admission, in-hospital survival. RESULTS: Only 6% of people who arrested in winter survived to discharge, compared to 8% of those who arrested in summer (odds ratio 0.77, p < 0.001). People who arrested in winter had a poorer risk profile in that they were older, more likely to arrest at home, less likely to have a witness, and less likely to receive defibrillation. However, after adjustment for case mix, people who arrested in winter were still 19% less likely to survive compared to those who arrested in summer. Deaths pre-admission were significantly higher in winter (odds ratio 1.18, p < 0.05) but in-hospital deaths were not. CONCLUSIONS:People who suffer cardiopulmonary arrest in winter have a significantly lower likelihood of surviving. This is, in part, caused by the higher frequency of a number of recognised risk factors. However, their prognosis remains poorer even after adjustment for these factors.
Authors: Adrian G Barnett; Annette J Dobson; Patrick McElduff; Veikko Salomaa; Kari Kuulasmaa; Susana Sans Journal: J Epidemiol Community Health Date: 2005-07 Impact factor: 3.710
Authors: David A Harrison; Panuwat Lertsithichai; Anthony R Brady; James R Carpenter; Kathy Rowan Journal: Intensive Care Med Date: 2004-08-06 Impact factor: 17.440
Authors: Gavin D Perkins; Malcolm Woollard; Matthew W Cooke; Charles Deakin; Jessica Horton; Ranjit Lall; Sarah E Lamb; Chris McCabe; Tom Quinn; Anne Slowther; Simon Gates Journal: Scand J Trauma Resusc Emerg Med Date: 2010-11-05 Impact factor: 2.953
Authors: Xaquin Castro Dopico; Marina Evangelou; Ricardo C Ferreira; Hui Guo; Marcin L Pekalski; Deborah J Smyth; Nicholas Cooper; Oliver S Burren; Anthony J Fulford; Branwen J Hennig; Andrew M Prentice; Anette-G Ziegler; Ezio Bonifacio; Chris Wallace; John A Todd Journal: Nat Commun Date: 2015-05-12 Impact factor: 14.919