Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China.
Am J Emerg Med. 2019 Mar;37(3):524-529. doi: 10.1016/j.ajem.2019.01.004. Epub 2019 Jan 3.
The relationship between time of day and the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. We undertook a meta-analysis to assess the available evidence on the relationship between nighttime and prognosis for patients with OHCA.
PubMed and EMBASE were searched through June 20, 2018, to identify all studies assessing the relationship between nighttime and prognosis for patients with OHCA. Random effects modes were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs).
Eight observational studies met the inclusion criteria. Meta-analysis of 8 studies showed that compared with nighttime, the daytime OHCA patients had higher 1-month/in-hospital survival (OR, 1.25; 95% CI, 1.15-1.37; P = 0.00), with high heterogeneity among the studies (I = 82.8%, P = 0.00).
Patients who experienced OHCA during the nighttime had lower 1-month/in-hospital survival than those with daytime OHCA. In addition to arrest event and pre-hospital care factors, patients' comorbidity and hospital-based care may also be responsible for lower survival at night.
院外心脏骤停（OHCA）患者的发病时间与临床结局之间的关系尚无定论。我们进行了一项荟萃分析，以评估有关 OHCA 患者夜间时间与预后之间关系的现有证据。
通过 2018 年 6 月 20 日检索 PubMed 和 EMBASE，以确定所有评估 OHCA 患者夜间时间与预后之间关系的研究。使用随机效应模型来估计优势比（OR）及其 95％置信区间（CI）。
符合纳入标准的有 8 项观察性研究。对 8 项研究的荟萃分析表明，与夜间相比，白天 OHCA 患者的 1 个月/院内生存率更高（OR，1.25；95％CI，1.15-1.37；P=0.00），但研究之间存在高度异质性（I=82.8％，P=0.00）。
夜间发生 OHCA 的患者 1 个月/院内生存率低于白天发生 OHCA 的患者。除了骤停事件和院前护理因素外，患者的合并症和医院内护理也可能导致夜间生存率降低。
