C Schriefl1, F B Mayr2, M Poppe1, A Zajicek3, A Nürnberger1, C Clodi1, H Herkner1, P Sulzgruber4, E Lobmeyr1, A Schober1, M Holzer1, F Sterz1, T Uray5. 1. Department of Emergency Medicine, Medical University of Vienna, Austria. 2. VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 3. Municipal Ambulance Service Vienna, Austria. 4. Department of Cardiology, Medical University of Vienna, Austria. 5. Department of Emergency Medicine, Medical University of Vienna, Austria. Electronic address: thomas.uray@meduniwien.ac.at.
Abstract
AIM: Whether time of day influences survival after out-of-hospital cardiac arrest (OHCA) remains controversial. We compared outcomes after OHCA between day and night and explored whether characteristics of pre-hospital advanced life support (ALS)-quality varied by time of day. METHODS: We conducted a prospective cohort study of individuals that suffered a non-traumatic OHCA in the city of Vienna between August 2013 and August 2015 and who received resuscitative efforts by EMS. We compared clinical outcomes between day and night, defined as 7:00 pm-7:00 am based on EMS shift time including rates of sustained return of spontaneous circulation (ROSC), 30-day survival and favourable neurologic outcome (cerebral performance category 1 or 2). ALS quality measures included time to first medical contact, time to first shock, total dose of epinephrine, and multiple ALS performance measures. RESULTS: We included 1811 patients (37% female) with a mean age of 67 ± 16 years in our analyses. Rates of ROSC and 30-day survival with favourable neurological outcome did not differ between day or night (30% vs 28%, p = 0.33; 12% vs. 11%, p = 0.51, respectively). These results remained unchanged after multivariate adjustment for ROSC (RR, 1.1; 95% CI, 1.0-1.3, p = 0.19) and 30-day survival with favourable neurological outcome (RR, 1.2; 95% CI, 1.0-1.5, p = 0.10). The quality of ALS did not differ between day and night. CONCLUSIONS: In contrast to previous studies, there was no significant difference in sustained ROSC rates and 30-day survival with favourable neurological outcome after OHCA between day and night in the city of Vienna. This is likely due to nearly identical high bystander CPR rates and identical ALS performance provided by EMS personnel irrespective of time of the day.
AIM: Whether time of day influences survival after out-of-hospital cardiac arrest (OHCA) remains controversial. We compared outcomes after OHCA between day and night and explored whether characteristics of pre-hospital advanced life support (ALS)-quality varied by time of day. METHODS: We conducted a prospective cohort study of individuals that suffered a non-traumatic OHCA in the city of Vienna between August 2013 and August 2015 and who received resuscitative efforts by EMS. We compared clinical outcomes between day and night, defined as 7:00 pm-7:00 am based on EMS shift time including rates of sustained return of spontaneous circulation (ROSC), 30-day survival and favourable neurologic outcome (cerebral performance category 1 or 2). ALS quality measures included time to first medical contact, time to first shock, total dose of epinephrine, and multiple ALS performance measures. RESULTS: We included 1811 patients (37% female) with a mean age of 67 ± 16 years in our analyses. Rates of ROSC and 30-day survival with favourable neurological outcome did not differ between day or night (30% vs 28%, p = 0.33; 12% vs. 11%, p = 0.51, respectively). These results remained unchanged after multivariate adjustment for ROSC (RR, 1.1; 95% CI, 1.0-1.3, p = 0.19) and 30-day survival with favourable neurological outcome (RR, 1.2; 95% CI, 1.0-1.5, p = 0.10). The quality of ALS did not differ between day and night. CONCLUSIONS: In contrast to previous studies, there was no significant difference in sustained ROSC rates and 30-day survival with favourable neurological outcome after OHCA between day and night in the city of Vienna. This is likely due to nearly identical high bystander CPR rates and identical ALS performance provided by EMS personnel irrespective of time of the day.
Authors: Christoph Schriefl; Christian Schoergenhofer; Michael Poppe; Christian Clodi; Matthias Mueller; Florian Ettl; Bernd Jilma; Juergen Grafeneder; Michael Schwameis; Heidrun Losert; Michael Holzer; Fritz Sterz; Andrea Zeiner-Schatzl Journal: Sci Rep Date: 2021-05-13 Impact factor: 4.379
Authors: Dae Kon Kim; Sang Do Shin; Young Sun Ro; Kyoung Jun Song; Ki Jeong Hong; So Yeon Joyce Kong Journal: PLoS One Date: 2020-05-15 Impact factor: 3.240
Authors: Christoph Schriefl; Michael Schwameis; Florian Ettl; Michael Poppe; Christian Clodi; Matthias Mueller; Juergen Grafeneder; Farsad Eskandary; Roman Reindl-Schwaighofer; Alexandra-Maria Warenits; Alexander Kupis; Michael Holzer; Fritz Sterz; Christian Schoergenhofer Journal: Eur J Anaesthesiol Date: 2022-04-01 Impact factor: 4.330