Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Emergency Medical Services and Pre-hospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon.
Resuscitation. 2019 Oct;143:29-34. doi: 10.1016/j.resuscitation.2019.08.004. Epub 2019 Aug 8.
Cardiac arrests are a leading cause of mortality with survival of only 12%. In the United States, cardiac arrests were significantly more likely to occur on Saturdays. Hospitals experience a decrease in staffing on weekends. This study aims to assess the relationship between weekend vs weekday admission and outcomes of patients presenting with out of hospital cardiac arrests (OHCA) in the United States.
This retrospective study utilized the 2014 US National Emergency Department Sample (NEDS) database. Patients who sustained out of hospital cardiac arrests were included using ICD-9-CM codes. Descriptive analysis was conducted, followed by bivariate analysis to compare the collected variables by admission day. Multivariate analysis was done to assess the impact of weekday vs weekend admission on survival of cardiac arrests patients after adjusting for confounders.
A total of 145,774 patients with cardiac arrest were included in this study. Mean age was 65.9 years with male predominance of 61.8%. Almost 71% of cardiac arrests took place on a weekday. As an overall outcome, only 5.7% patients survived to hospital discharge. After adjusting for significant confounders, patients presenting on weekends were less likely to survive compared to those admitted on weekdays (OR = 0.833, 95% CI: 0.727-0.954).
In this study, patients with OHCA admitted to the ED on weekends had slightly lower survival compared to those admitted on weekdays. Modifiable factors should be identified in future studies to reduce outcome discrepancies and improve survival in this patient population.
心脏骤停是导致死亡的主要原因，存活率仅为 12%。在美国，心脏骤停更有可能发生在周六。医院在周末的人员配备会减少。本研究旨在评估美国心脏骤停患者（OHCA）在周末和工作日入院与预后之间的关系。
本回顾性研究使用了 2014 年美国国家急诊部样本（NEDS）数据库。使用 ICD-9-CM 编码纳入了发生院外心脏骤停的患者。进行了描述性分析，然后进行了双变量分析，以比较入院日的收集变量。进行了多变量分析，以评估在调整混杂因素后，工作日与周末入院对心脏骤停患者存活率的影响。
本研究共纳入了 145774 例心脏骤停患者。平均年龄为 65.9 岁，男性占 61.8%。近 71%的心脏骤停发生在工作日。作为总体预后，仅有 5.7%的患者存活至出院。在调整了显著混杂因素后，与工作日入院相比，周末入院的患者存活的可能性较小（OR=0.833，95%CI：0.727-0.954）。
在这项研究中，与工作日入院相比，周末到急诊就诊的 OHCA 患者的存活率略低。未来的研究应确定可改变的因素，以减少该患者人群的预后差异并提高生存率。
