Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study

Yosuke Matsumura; Taka aki Nakada; Koichiro Shinozaki; Takashi Tagami; Tomohisa Nomura; Yoshio Tahara; Atsushi Sakurai; Naohiro Yonemoto; Ken Nagao; Arino Yaguchi; Naoto Morimura; Tagami Takashi; Dai Miyazaki; Tomoko Ogasawara; Kei Hayashida; Masaru Suzuki; Mari Amino; Nobuya Kitamura; Naoki Shimizu; Akiko Akashi; Sadaki Inokuchi; Yoshihiro Masui; Kunihisa Miura; Haruhiko Tsutsumi; Kiyotsugu Takuma; Ishihara Atsushi; Minoru Nakano; Hiroshi Tanaka; Keiichi Ikegami; Takao Arai; Shigeto Oda; Kenji Kobayashi; Takayuki Suda; Kazuyuki Ono; Ryosuke Furuya; Yuichi Koido; Fumiaki Iwase; Shigeru Kanesaka; Yasusei Okada; Kyoko Unemoto; Tomohito Sadahiro; Masayuki Iyanaga; Asaki Muraoka; Munehiro Hayashi; Shinichi Ishimatsu; Yasufumi Miyake; Hideo Yokokawa; Yasuaki Koyama; Asuka Tsuchiya; Tetsuya Kashiyama; Kiyohiro Oshima; Kazuya Kiyota; Yuichi Hamabe; Hiroyuki Yokota; Shingo Hori; Shin Inaba; Tetsuya Sakamoto; Naoshige Harada; Akio Kimura; Masayuki Kanai; Yasuhiro Otomo; Manabu Sugita; Kosaku Kinoshita; Mitsuhide Kitano; Kiyoshi Matsuda; Kotaro Tanaka; Katsunori Yoshihara; Kikuo Yoh; Junichi Suzuki; Hiroshi Toyoda; Kunihiro Mashiko; Takashi Muguruma; Tadanaga Shimada; Yoshiro Kobe; Tomohisa Shoko; Kazuya Nakanishi; Takashi Shiga; Takefumi Yamamoto; Kazuhiko Sekine; Shinichi Izuka

doi:10.1186/s13054-016-1323-4

Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study

Yosuke Matsumura, Taka aki Nakada, Koichiro Shinozaki, Takashi Tagami, Tomohisa Nomura, Yoshio Tahara, Atsushi Sakurai, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura, Tagami Takashi, Dai Miyazaki, Tomoko Ogasawara, Kei Hayashida, Masaru Suzuki, Mari Amino, Nobuya Kitamura, Naoki Shimizu, Akiko AkashiSadaki Inokuchi, Yoshihiro Masui, Kunihisa Miura, Haruhiko Tsutsumi, Kiyotsugu Takuma, Ishihara Atsushi, Minoru Nakano, Hiroshi Tanaka, Keiichi Ikegami, Takao Arai, Shigeto Oda, Kenji Kobayashi, Takayuki Suda, Kazuyuki Ono, Ryosuke Furuya, Yuichi Koido, Fumiaki Iwase, Shigeru Kanesaka, Yasusei Okada, Kyoko Unemoto, Tomohito Sadahiro, Masayuki Iyanaga, Asaki Muraoka, Munehiro Hayashi, Shinichi Ishimatsu, Yasufumi Miyake, Hideo Yokokawa, Yasuaki Koyama, Asuka Tsuchiya, Tetsuya Kashiyama, Kiyohiro Oshima, Kazuya Kiyota, Yuichi Hamabe, Hiroyuki Yokota, Shingo Hori, Shin Inaba, Tetsuya Sakamoto, Naoshige Harada, Akio Kimura, Masayuki Kanai, Yasuhiro Otomo, Manabu Sugita, Kosaku Kinoshita, Mitsuhide Kitano, Kiyoshi Matsuda, Kotaro Tanaka, Katsunori Yoshihara, Kikuo Yoh, Junichi Suzuki, Hiroshi Toyoda, Kunihiro Mashiko, Takashi Muguruma, Tadanaga Shimada, Yoshiro Kobe, Tomohisa Shoko, Kazuya Nakanishi, Takashi Shiga, Takefumi Yamamoto, Kazuhiko Sekine, Shinichi Izuka

Department of Emergency and Critical Care Medicine

Research output: Contribution to journal › Article › peer-review

36 Citations (Scopus)

Abstract

Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34-2.07; P < 0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93-0.96; bystander CPR: OR 0.85 and 95 % CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.

Original language	English
Article number	141
Journal	Critical Care
Volume	20
Issue number	1
DOIs	https://doi.org/10.1186/s13054-016-1323-4
Publication status	Published - 2016 May 10

Keywords

Cardiopulmonary resuscitation
Circadian rhythm
Heart arrest
Out-of-hospital cardiac arrest
Resuscitation

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine

Access to Document

10.1186/s13054-016-1323-4

Cite this

Matsumura, Y., Nakada, T. A., Shinozaki, K., Tagami, T., Nomura, T., Tahara, Y., Sakurai, A., Yonemoto, N., Nagao, K., Yaguchi, A., Morimura, N., Takashi, T., Miyazaki, D., Ogasawara, T., Hayashida, K., Suzuki, M., Amino, M., Kitamura, N., Shimizu, N., ... Izuka, S. (2016). Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study. Critical Care, 20(1), Article 141. https://doi.org/10.1186/s13054-016-1323-4

Matsumura, Y, Nakada, TA, Shinozaki, K, Tagami, T, Nomura, T, Tahara, Y, Sakurai, A, Yonemoto, N, Nagao, K, Yaguchi, A, Morimura, N, Takashi, T, Miyazaki, D, Ogasawara, T, Hayashida, K, Suzuki, M, Amino, M, Kitamura, N, Shimizu, N, Akashi, A, Inokuchi, S, Masui, Y, Miura, K, Tsutsumi, H, Takuma, K, Atsushi, I, Nakano, M, Tanaka, H, Ikegami, K, Arai, T, Oda, S, Kobayashi, K, Suda, T, Ono, K, Furuya, R, Koido, Y, Iwase, F, Kanesaka, S, Okada, Y, Unemoto, K, Sadahiro, T, Iyanaga, M, Muraoka, A, Hayashi, M, Ishimatsu, S, Miyake, Y, Yokokawa, H, Koyama, Y, Tsuchiya, A, Kashiyama, T, Oshima, K, Kiyota, K, Hamabe, Y, Yokota, H, Hori, S, Inaba, S, Sakamoto, T, Harada, N, Kimura, A, Kanai, M, Otomo, Y, Sugita, M, Kinoshita, K, Kitano, M, Matsuda, K, Tanaka, K, Yoshihara, K, Yoh, K, Suzuki, J, Toyoda, H, Mashiko, K, Muguruma, T, Shimada, T, Kobe, Y, Shoko, T, Nakanishi, K, Shiga, T, Yamamoto, T, Sekine, K & Izuka, S 2016, 'Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study', Critical Care, vol. 20, no. 1, 141. https://doi.org/10.1186/s13054-016-1323-4

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title = "Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study",

abstract = "Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34-2.07; P < 0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93-0.96; bystander CPR: OR 0.85 and 95 % CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.",

keywords = "Cardiopulmonary resuscitation, Circadian rhythm, Heart arrest, Out-of-hospital cardiac arrest, Resuscitation",

author = "Yosuke Matsumura and Nakada, {Taka aki} and Koichiro Shinozaki and Takashi Tagami and Tomohisa Nomura and Yoshio Tahara and Atsushi Sakurai and Naohiro Yonemoto and Ken Nagao and Arino Yaguchi and Naoto Morimura and Tagami Takashi and Dai Miyazaki and Tomoko Ogasawara and Kei Hayashida and Masaru Suzuki and Mari Amino and Nobuya Kitamura and Naoki Shimizu and Akiko Akashi and Sadaki Inokuchi and Yoshihiro Masui and Kunihisa Miura and Haruhiko Tsutsumi and Kiyotsugu Takuma and Ishihara Atsushi and Minoru Nakano and Hiroshi Tanaka and Keiichi Ikegami and Takao Arai and Shigeto Oda and Kenji Kobayashi and Takayuki Suda and Kazuyuki Ono and Ryosuke Furuya and Yuichi Koido and Fumiaki Iwase and Shigeru Kanesaka and Yasusei Okada and Kyoko Unemoto and Tomohito Sadahiro and Masayuki Iyanaga and Asaki Muraoka and Munehiro Hayashi and Shinichi Ishimatsu and Yasufumi Miyake and Hideo Yokokawa and Yasuaki Koyama and Asuka Tsuchiya and Tetsuya Kashiyama and Kiyohiro Oshima and Kazuya Kiyota and Yuichi Hamabe and Hiroyuki Yokota and Shingo Hori and Shin Inaba and Tetsuya Sakamoto and Naoshige Harada and Akio Kimura and Masayuki Kanai and Yasuhiro Otomo and Manabu Sugita and Kosaku Kinoshita and Mitsuhide Kitano and Kiyoshi Matsuda and Kotaro Tanaka and Katsunori Yoshihara and Kikuo Yoh and Junichi Suzuki and Hiroshi Toyoda and Kunihiro Mashiko and Takashi Muguruma and Tadanaga Shimada and Yoshiro Kobe and Tomohisa Shoko and Kazuya Nakanishi and Takashi Shiga and Takefumi Yamamoto and Kazuhiko Sekine and Shinichi Izuka",

note = "Funding Information: This study was supported by the Japanese Association for Acute Medicine of Kanto. The funder had no role in the execution of this study or interpretation of the results. We acknowledge the SOS-KANTO 2012 Steering Council Yokohama City University Medical Center, Kanagawa (President, Naoto Morimura MD); Nihon University School of Medicine, Tokyo (Director, Atsushi Sakurai MD); National Cerebral and Cardiovascular Center Hospital, Osaka (Director,Yoshio Tahara MD); Tokyo Women{\textquoteright}s Medical University Hospital, Tokyo (Arino Yaguchi MD); Nihon University Surugadai Hospital, Tokyo (Ken Nagao MD); Nippon Medical School Hospital, Tokyo (Tagami Takashi MD); Japanese Red Cross Maebashi Hospital, Gunma (Dai Miyazaki MD); National Disaster Medical Center, Tokyo (Tomoko Ogasawara MD); Keio University Hospital, Tokyo (Kei Hayashida MD, Masaru Suzuki MD);Tokai University School of Medicine, Kanagawa (Mari Amino MD); Kimitsu Chuo Hospital, Chiba (Nobuya Kitamura MD); Juntendo University Nerima Hospital, Tokyo (Tomohisa Nomura MD); Tokyo Metropolitan Children{\textquoteright}s Medical Center, Tokyo (Naoki Shimizu MD); Tokyo Metropolitan Bokutoh Hospital, Tokyo (Akiko Akashi MD), National Center of Neurology and Psychiatry, Tokyo, Japan (NaohiroYonemoto DPH). We also acknowledge the SOS-KANTO 2012 Study Group: Tokai University School of Medicine (Sadaki Inokuchi MD); St. Marianna University School of Medicine, Yokohama Seibu Hospital (Yoshihiro Masui MD); Koto Hospital (Kunihisa Miura MD); Saitama Medical Center Advanced Tertiary Medical Center (Haruhiko Tsutsumi MD); Kawasaki Municipal Hospital Emergency and Critical Care Center (Kiyotsugu Takuma MD); Yokohama Municipal Citizen{\textquoteright}s Hospital (Ishihara Atsushi MD); Japanese Red Cross Maebashi Hospital (Minoru Nakano MD); Juntendo University Urayasu Hospital (Hiroshi Tanaka MD); Dokkyo Medical University Koshigaya Hospital (Keiichi Ikegami MD); Hachioji Medical Center of Tokyo Medical University (Takao Arai MD); Tokyo Women{\textquoteright}s Medical University Hospital (Arino Yaguchi MD); Kimitsu Chuo Hospital (Nobuya Kitamura MD); Chiba University Graduate School of Medicine (Shigeto Oda MD); Saiseikai Utsunomiya Hospital (Kenji Kobayashi MD); Mito Saiseikai General Hospital (Takayuki Suda MD); Dokkyo Medical University (Kazuyuki Ono MD); Yokohama City University Medical Center (Naoto Morimura MD); National Hospital Organization Yokohama Medical Center (Ryosuke Furuya MD); National Disaster Medical Center (Yuichi Koido MD); Yamanashi Prefectural Central Hospital (Fumiaki Iwase MD); Surugadai Nihon University Hospital (Ken Nagao MD); Yokohama Rosai Hospital (Shigeru Kanesaka MD); Showa General Hospital (Yasusei Okada MD); Nippon Medical School Tamanagayama Hospital (Kyoko Unemoto MD); Tokyo Women{\textquoteright}s Medical University Yachiyo Medical Center (Tomohito Sadahiro MD); Awa Regional Medical Center (Masayuki Iyanaga MD); Todachuo General Hospital (Asaki Muraoka MD); Japanese Red Cross Medical Center (Munehiro Hayashi MD); St. Luke{\textquoteright}s International Hospital (Shinichi Ishimatsu MD); Showa University School of Medicine (Yasufumi Miyake MD); Totsuka Kyoritsu Hospital 1 (Hideo Yokokawa MD); St. Marianna University School of Medicine (Yasuaki Koyama MD); National Hospital Organization Mito Medical Center (Asuka Tsuchiya MD); Tokyo Metropolitan Tama Medical Center (Tetsuya Kashiyama MD); Showa University Fujigaoka Hospital (Munetaka Hayashi MD); Gunma University Graduate School of Medicine (Kiyohiro Oshima MD); Saitama Red Cross Hospital (Kazuya Kiyota MD); Tokyo Metropolitan Bokutoh Hospital (Yuichi Hamabe MD); Nippon Medical School Hospital (Hiroyuki Yokota MD); Keio University Hospital (Shingo Hori MD); Chiba Emergency Medical Center (Shin Inaba MD); Teikyo University School of Medicine (Tetsuya Sakamoto MD); Japanese Red Cross Musashino Hospital (Naoshige Harada MD); National Center for Global Health and Medicine Hospital (Akio Kimura MD); Tokyo Metropolitan Police Hospital (Masayuki Kanai MD); Medical Hospital of Tokyo Medical and Dental University (Yasuhiro Otomo MD); Juntendo University Nerima Hospital (Manabu Sugita MD); Nihon University School of Medicine (Kosaku Kinoshita MD); Toho University Ohashi Medical Center (Takatoshi Sakurai MD); Saiseikai Yokohamashi Tobu Hospital (Mitsuhide Kitano MD); Nippon Medical School Musashikosugi Hospital (Kiyoshi Matsuda MD); Tokyo Rosai Hospital (Kotaro Tanaka MD); Toho University Omori Medical Center (Katsunori Yoshihara MD); Hiratsuka City Hospital (KikuoYoh MD); Yokosuka Kyosai Hospital (Junichi Suzuki MD); Saiseikai Yokohamashi Nambu Hospital (Hiroshi Toyoda MD); Nippon Medical School Chiba Hokusoh Hospital (Kunihiro Mashiko MD); Tokyo Metropolitan Children{\textquoteright}s Medical Center (Naoki Shimizu MD); National Medical Center for Children and Mothers (Takashi Muguruma MD); Chiba Aoba Municipal Hospital (Tadanaga Shimada MD); Kuki General Hospital (Yoshiro Kobe MD); Matsudo City Hospital (Tomohisa Shoko MD); Japanese Red Cross Narita Hospital (Kazuya Nakanishi MD); Tokyo Bay Urayasu/ Ichikawa Medical Center (Takashi Shiga MD); NTT Medical Center Tokyo (Takefumi Yamamoto MD); Tokyo Saiseikai Central Hospital (Kazuhiko Sekine MD); Fuji Heavy Industries Health Insurance Society OTA Memorial Hospital (Shinichi Izuka MD). Publisher Copyright: {\textcopyright} 2016 Matsumura et al.",

year = "2016",

month = may,

day = "10",

doi = "10.1186/s13054-016-1323-4",

language = "English",

volume = "20",

journal = "Critical Care",

issn = "1364-8535",

publisher = "BioMed Central Ltd.",

number = "1",

}

TY - JOUR

T1 - Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests

T2 - A prospective observational study

AU - Matsumura, Yosuke

AU - Nakada, Taka aki

AU - Shinozaki, Koichiro

AU - Tagami, Takashi

AU - Nomura, Tomohisa

AU - Tahara, Yoshio

AU - Sakurai, Atsushi

AU - Yonemoto, Naohiro

AU - Nagao, Ken

AU - Yaguchi, Arino

AU - Morimura, Naoto

AU - Takashi, Tagami

AU - Miyazaki, Dai

AU - Ogasawara, Tomoko

AU - Hayashida, Kei

AU - Suzuki, Masaru

AU - Amino, Mari

AU - Kitamura, Nobuya

AU - Shimizu, Naoki

AU - Akashi, Akiko

AU - Inokuchi, Sadaki

AU - Masui, Yoshihiro

AU - Miura, Kunihisa

AU - Tsutsumi, Haruhiko

AU - Takuma, Kiyotsugu

AU - Atsushi, Ishihara

AU - Nakano, Minoru

AU - Tanaka, Hiroshi

AU - Ikegami, Keiichi

AU - Arai, Takao

AU - Oda, Shigeto

AU - Kobayashi, Kenji

AU - Suda, Takayuki

AU - Ono, Kazuyuki

AU - Furuya, Ryosuke

AU - Koido, Yuichi

AU - Iwase, Fumiaki

AU - Kanesaka, Shigeru

AU - Okada, Yasusei

AU - Unemoto, Kyoko

AU - Sadahiro, Tomohito

AU - Iyanaga, Masayuki

AU - Muraoka, Asaki

AU - Hayashi, Munehiro

AU - Ishimatsu, Shinichi

AU - Miyake, Yasufumi

AU - Yokokawa, Hideo

AU - Koyama, Yasuaki

AU - Tsuchiya, Asuka

AU - Kashiyama, Tetsuya

AU - Oshima, Kiyohiro

AU - Kiyota, Kazuya

AU - Hamabe, Yuichi

AU - Yokota, Hiroyuki

AU - Hori, Shingo

AU - Inaba, Shin

AU - Sakamoto, Tetsuya

AU - Harada, Naoshige

AU - Kimura, Akio

AU - Kanai, Masayuki

AU - Otomo, Yasuhiro

AU - Sugita, Manabu

AU - Kinoshita, Kosaku

AU - Kitano, Mitsuhide

AU - Matsuda, Kiyoshi

AU - Tanaka, Kotaro

AU - Yoshihara, Katsunori

AU - Yoh, Kikuo

AU - Suzuki, Junichi

AU - Toyoda, Hiroshi

AU - Mashiko, Kunihiro

AU - Muguruma, Takashi

AU - Shimada, Tadanaga

AU - Kobe, Yoshiro

AU - Shoko, Tomohisa

AU - Nakanishi, Kazuya

AU - Shiga, Takashi

AU - Yamamoto, Takefumi

AU - Sekine, Kazuhiko

AU - Izuka, Shinichi

N1 - Funding Information: This study was supported by the Japanese Association for Acute Medicine of Kanto. The funder had no role in the execution of this study or interpretation of the results. We acknowledge the SOS-KANTO 2012 Steering Council Yokohama City University Medical Center, Kanagawa (President, Naoto Morimura MD); Nihon University School of Medicine, Tokyo (Director, Atsushi Sakurai MD); National Cerebral and Cardiovascular Center Hospital, Osaka (Director,Yoshio Tahara MD); Tokyo Women’s Medical University Hospital, Tokyo (Arino Yaguchi MD); Nihon University Surugadai Hospital, Tokyo (Ken Nagao MD); Nippon Medical School Hospital, Tokyo (Tagami Takashi MD); Japanese Red Cross Maebashi Hospital, Gunma (Dai Miyazaki MD); National Disaster Medical Center, Tokyo (Tomoko Ogasawara MD); Keio University Hospital, Tokyo (Kei Hayashida MD, Masaru Suzuki MD);Tokai University School of Medicine, Kanagawa (Mari Amino MD); Kimitsu Chuo Hospital, Chiba (Nobuya Kitamura MD); Juntendo University Nerima Hospital, Tokyo (Tomohisa Nomura MD); Tokyo Metropolitan Children’s Medical Center, Tokyo (Naoki Shimizu MD); Tokyo Metropolitan Bokutoh Hospital, Tokyo (Akiko Akashi MD), National Center of Neurology and Psychiatry, Tokyo, Japan (NaohiroYonemoto DPH). We also acknowledge the SOS-KANTO 2012 Study Group: Tokai University School of Medicine (Sadaki Inokuchi MD); St. Marianna University School of Medicine, Yokohama Seibu Hospital (Yoshihiro Masui MD); Koto Hospital (Kunihisa Miura MD); Saitama Medical Center Advanced Tertiary Medical Center (Haruhiko Tsutsumi MD); Kawasaki Municipal Hospital Emergency and Critical Care Center (Kiyotsugu Takuma MD); Yokohama Municipal Citizen’s Hospital (Ishihara Atsushi MD); Japanese Red Cross Maebashi Hospital (Minoru Nakano MD); Juntendo University Urayasu Hospital (Hiroshi Tanaka MD); Dokkyo Medical University Koshigaya Hospital (Keiichi Ikegami MD); Hachioji Medical Center of Tokyo Medical University (Takao Arai MD); Tokyo Women’s Medical University Hospital (Arino Yaguchi MD); Kimitsu Chuo Hospital (Nobuya Kitamura MD); Chiba University Graduate School of Medicine (Shigeto Oda MD); Saiseikai Utsunomiya Hospital (Kenji Kobayashi MD); Mito Saiseikai General Hospital (Takayuki Suda MD); Dokkyo Medical University (Kazuyuki Ono MD); Yokohama City University Medical Center (Naoto Morimura MD); National Hospital Organization Yokohama Medical Center (Ryosuke Furuya MD); National Disaster Medical Center (Yuichi Koido MD); Yamanashi Prefectural Central Hospital (Fumiaki Iwase MD); Surugadai Nihon University Hospital (Ken Nagao MD); Yokohama Rosai Hospital (Shigeru Kanesaka MD); Showa General Hospital (Yasusei Okada MD); Nippon Medical School Tamanagayama Hospital (Kyoko Unemoto MD); Tokyo Women’s Medical University Yachiyo Medical Center (Tomohito Sadahiro MD); Awa Regional Medical Center (Masayuki Iyanaga MD); Todachuo General Hospital (Asaki Muraoka MD); Japanese Red Cross Medical Center (Munehiro Hayashi MD); St. Luke’s International Hospital (Shinichi Ishimatsu MD); Showa University School of Medicine (Yasufumi Miyake MD); Totsuka Kyoritsu Hospital 1 (Hideo Yokokawa MD); St. Marianna University School of Medicine (Yasuaki Koyama MD); National Hospital Organization Mito Medical Center (Asuka Tsuchiya MD); Tokyo Metropolitan Tama Medical Center (Tetsuya Kashiyama MD); Showa University Fujigaoka Hospital (Munetaka Hayashi MD); Gunma University Graduate School of Medicine (Kiyohiro Oshima MD); Saitama Red Cross Hospital (Kazuya Kiyota MD); Tokyo Metropolitan Bokutoh Hospital (Yuichi Hamabe MD); Nippon Medical School Hospital (Hiroyuki Yokota MD); Keio University Hospital (Shingo Hori MD); Chiba Emergency Medical Center (Shin Inaba MD); Teikyo University School of Medicine (Tetsuya Sakamoto MD); Japanese Red Cross Musashino Hospital (Naoshige Harada MD); National Center for Global Health and Medicine Hospital (Akio Kimura MD); Tokyo Metropolitan Police Hospital (Masayuki Kanai MD); Medical Hospital of Tokyo Medical and Dental University (Yasuhiro Otomo MD); Juntendo University Nerima Hospital (Manabu Sugita MD); Nihon University School of Medicine (Kosaku Kinoshita MD); Toho University Ohashi Medical Center (Takatoshi Sakurai MD); Saiseikai Yokohamashi Tobu Hospital (Mitsuhide Kitano MD); Nippon Medical School Musashikosugi Hospital (Kiyoshi Matsuda MD); Tokyo Rosai Hospital (Kotaro Tanaka MD); Toho University Omori Medical Center (Katsunori Yoshihara MD); Hiratsuka City Hospital (KikuoYoh MD); Yokosuka Kyosai Hospital (Junichi Suzuki MD); Saiseikai Yokohamashi Nambu Hospital (Hiroshi Toyoda MD); Nippon Medical School Chiba Hokusoh Hospital (Kunihiro Mashiko MD); Tokyo Metropolitan Children’s Medical Center (Naoki Shimizu MD); National Medical Center for Children and Mothers (Takashi Muguruma MD); Chiba Aoba Municipal Hospital (Tadanaga Shimada MD); Kuki General Hospital (Yoshiro Kobe MD); Matsudo City Hospital (Tomohisa Shoko MD); Japanese Red Cross Narita Hospital (Kazuya Nakanishi MD); Tokyo Bay Urayasu/ Ichikawa Medical Center (Takashi Shiga MD); NTT Medical Center Tokyo (Takefumi Yamamoto MD); Tokyo Saiseikai Central Hospital (Kazuhiko Sekine MD); Fuji Heavy Industries Health Insurance Society OTA Memorial Hospital (Shinichi Izuka MD). Publisher Copyright: © 2016 Matsumura et al.

PY - 2016/5/10

Y1 - 2016/5/10

N2 - Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34-2.07; P < 0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93-0.96; bystander CPR: OR 0.85 and 95 % CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.

AB - Background: Whether temporal differences alter the clinical outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. Furthermore, the relationship between time of day and resuscitation efforts is unknown. Methods: We studied adult OHCA patients in the Survey of Survivors after Out-of-Hospital Cardiac Arrest in the Kanto Region (SOS-KANTO) 2012 study from January 2012 to March 2013 in Japan. The primary variable was 1-month survival. The secondary outcome variables were prehospital and in-hospital resuscitation efforts by bystanders, emergency medical services personnel, and in-hospital healthcare providers. Daytime was defined as 0701 to 1500 h, evening was defined as 1501 to 2300 h, and night was defined as 2301 to 0700 h. Results: During the study period, 13,780 patients were included in the analysis. The patients with night OHCA had significantly lower 1-month survival compared to the patients with daytime OHCA (night vs. daytime, adjusted odds ratio (OR) 1.66; 95 % confidence interval (CI), 1.34-2.07; P < 0.0001). The nighttime OHCA patients had significantly shorter call-response intervals, bystander CPR, in-hospital intubation, and in-hospital blood gas analyses compared to the daytime and evening OHCA patients (call-response interval: OR 0.95 and 95 % CI 0.93-0.96; bystander CPR: OR 0.85 and 95 % CI 0.78-0.93; in-hospital intubation: OR 0.85 and 95 % CI 0.74-0.97; and in-hospital blood gas analysis: OR 0.86 and 95 % CI 0.75-0.98). Conclusions: There was a significant temporal difference in 1-month survival after OHCA. The nighttime OHCA patients had significantly decreased resuscitation efforts by bystanders and in-hospital healthcare providers compared to those with evening and daytime OHCA.

KW - Cardiopulmonary resuscitation

KW - Circadian rhythm

KW - Heart arrest

KW - Out-of-hospital cardiac arrest

KW - Resuscitation

UR - http://www.scopus.com/inward/record.url?scp=84971405850&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84971405850&partnerID=8YFLogxK

U2 - 10.1186/s13054-016-1323-4

DO - 10.1186/s13054-016-1323-4

M3 - Article

C2 - 27160587

AN - SCOPUS:84971405850

SN - 1364-8535

VL - 20

JO - Critical Care

JF - Critical Care

IS - 1

M1 - 141

ER -

Nighttime is associated with decreased survival and resuscitation efforts for out-of-hospital cardiac arrests: A prospective observational study

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