Key result
Out-of-hospital cardiac arrest peaks in the morning, showing ~2.5-fold higher incidence than at night.
Why the study?
The Polish experience regarding temporal variations in the incidence of out-of-hospital cardiac arrest was scarce.
Observational (n=815)
No
Absolute Event Rate: 32.4% vs 13%
p-value: p=<0.001
Morning peak in out-of-hospital cardiac arrest incidence; hypothesis-generating and requires prospective validation before guiding timed interventions.
BACKGROUND: Although recent studies indicate temporal variations in the incidence of out-of-hospital cardiac arrest (OHCA), the Polish experience in this research is scarce to date. We evaluated the epidemiology of OHCA and circadian, weekly and seasonal variations of OHCA frequency among the adult population of the Opole district, Poland. METHODS: The retrospective analysis of 815 OHCA cases with presumed cardiac etiology was made based on dispatch cards from the Emergency Medical Center in Opole registered during a 2 year period (2006-2007). RESULTS: The incidence of OHCA in the studied population was 1.56/1000 inhabitants per year. Mean age of the group was 69.2 ± 14.2 years, with the majority of men (63%), younger than women (66.1 vs. 74 years, p = 0.0001). The OHCA occurrence increased with age reaching a peak between 71 and 75 years. The incidence of OHCA stayed at stable low levels between 22:00 and 4:59 and started to increase at 5:00, with trimodal peaks: 8:00-10:59, 14:00-15:59 and 18.00-21.59. The lowest number of OHCA occurred from 00:00 to 5:59, the highest from 6:00 to 11:59 (13% vs. 32.4%, p < 0.001). The day with the lowest occurrence of OHCA was Friday, the highest Saturday (10.9% vs. 16%, p = 0.01). Summer was the season of the lowest incidence of OHCA, while winter - the highest (22.6% vs. 26%, p = 0.04). These seasons were the warmest and the coldest one, respectively (average temperature 18.5°C vs. 0°C, p < 0.001). CONCLUSIONS: Circadian and less marked, weekly variability in OHCA occurrence were confirmed. Existing seasonal differences may be affected by temperature. This is the first Polish analysis of a large subpopulation, which also includes seasonal temperature data.
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Szczerbiński et al. (2018) conducted an observational in Out-of-hospital cardiac arrest (n=815). Time of day (morning vs. night) vs. Night time (00:00 to 05:59) was evaluated on Frequency of out-of-hospital cardiac arrest by time of day (p=<0.001). The incidence of out-of-hospital cardiac arrest exhibited significant circadian variation, with the highest occurrence in the morning (32.4%) compared to the lowest at night (13%, p < 0.001).
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