A new study reveals that hospital patients who suffer
cardiac arrest at night or on the weekend are less likely to survive than those
who have a heart attack during weekdays or weekday evenings.
“Hospital simply don’t work the same at night as they do
during the day. There is enough data out there to suggest that this may be a
process issue that is at least contributing, and probably contributing substantially,”
study author Dr. Mary Ann Peberdy, an associate professor of internal medicine
and emergency medicine at Virginia Commonwealth University
in Richmond.
Dr. Peberdy and colleagues analyzed data covering period
from January 1, 2000 through February 1, 2007, provided by 507 hospitals in the
National Registry of Cardiopulmonary Resuscitation, sponsored by the American
Heart Association.
The data involved 86,748 adults who suffered heat attacks
while in the hospital. Of these cardiac events, 58,593 happened during day or
evening hours, including weekends. The remaining 28,155 events happened during
the night, also including weekend nights.
The researchers defined day/evening as 7 a.m. to 10:59 p.m.,
night as 11 p.m. to 6:59 a.m., and weekend as 11 p.m. Friday to 6:59 a.m.
Monday.
The study revealed that those who suffered cardiac arrests
during a weekday had a 24-hour recovery rate of 35.4 percent, and a 19.8
percent chance of surviving until they were discharged from the hospital. On
the other hand, for those who suffered cardiac arrest at night, those rates
fell to 28.9 percent and 14.7 percent. In addition, those who suffered from
cardiac arrests during the weekend had only a 14.6 chance of surviving.
Overall survival was 14.7 percent for nights-weekends, and
19.8 percent for weekdays.
Dr Peberdy offered several potential explanations for the
time-related differences in outcome: fewer supervisory personnel at night and
on weekends, decreased hospital staffing at night and on weekends, use of less
experienced healthcare personnel at night and on weekends and fewer hospital
visitors to alert hospital staff when patients have cardiac arrests.
She also said the findings “should be a pretty big wake-up
call to urge hospitals to critically evaluate how they are performing
resuscitation. It may well be possible that there is a less effective and less
efficient response at night. This paper really needs to go to hospital, and the
people who run them.”
This study follows a research conducted by Dr. Paul Chan of University of Michigan on January, which suggested
that almost a third of patients who suffer cardiac arrest in hospital do not
get a defibrillator-delivered shock to make the heart beating again within two
minutes how the American Heart Association recommends.
Dr. Peberdy’s findings were published in today’s issue of
the Journal of the American Medical Association.
