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Temporal variation in survival following in-hospital cardiac arrest in Sweden
Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Mölndal, Göteborgsvägen 31, Mölndal, 431 30, Sweden.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. (PreHospen)ORCID iD: 0000-0003-4139-6235
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Unit for EMS-coordination, Provider Governance and Coordination, Head Office, Region Västra Götaland, Vänersborg, SE 462 80, Sweden.
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2023 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 381, p. 112-119Article in journal (Refereed) Published
Abstract [en]

Background: The aim of the study was to investigate what characterizes IHCAs that take place during the “day” (Monday-Friday 7 am-3 pm), “evening” (Monday-Friday 3 pm–9 pm) and “night” (Monday-Friday 9 pm-7 am and Saturday-Sunday 12 am- 11.59 pm). Methods: We used the Swedish Registry for CPR (SRCR) to study 26,595 patients from January 1, 2008 to December 31, 2019. Adult patients ≥18 years with a IHCA where resuscitation was initiated were included. Uni- and multivariable logistic regression was used to investigate associations between temporal factors and survival to 30 days. Results: 30-day survival and Return of Spontaneous Circulation (ROSC) was 36.8% and 67.9% following CA during the day and decreased during the evening (32.0% and 66.3%) and night (26.2% and 60.2%) (p < 0.001 and p = 0.028). When comparing the survival rates between the day and the night, survival decreased more (change in relative survival rates) in small (<99 beds) compared to large (<400) hospitals (35.9% vs 25%), in non-academic vs academic hospitals (33.5% vs 22%) and on non-Electro Cardiogram (ECG)-monitored wards vs ECG-monitored wards (46.2% vs 20.9%) (p < 0.001 for all). IHCAs that took place during the day (adjusted Odds Ratio (aOR) 1.47 95% CI 1.35–1.60), in academic hospitals (aOR 1.14 95% CI 1.02–1.27) and in large (>400 beds) hospitals (aOR 1.31 95% CI 1.10–1.55) were independently associated with an increased chance of survival. Conclusions: Patients suffering an IHCA have an increased chance of survival during the day vs the evening vs night, and the difference in survival is even more pronounced when cared for at smaller, non-academic hospitals, general wards and wards without ECG-monitoring capacity. © 2023 The Author(s)

Place, publisher, year, edition, pages
2023. Vol. 381, p. 112-119
Keywords [en]
Cardiopulmonary resuscitation; Equality, In-hospital cardiac arrest, Time
National Category
Cardiology and Cardiovascular Disease
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-29730DOI: 10.1016/j.ijcard.2023.03.069ISI: 000995683300001Scopus ID: 2-s2.0-85151835072OAI: oai:DiVA.org:hb-29730DiVA, id: diva2:1753567
Available from: 2023-04-27 Created: 2023-04-27 Last updated: 2025-02-10Bibliographically approved

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Herlitz, Johan

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