Temporal variation in out-of-hospital cardiac arrest with validated cardiac cause
Tim Jallow1, Patrik Wennberg2, Ann-Sofie Forslund3
1a Sunderby Hospital , Luleå , Sweden.
Insights
Out-of-hospital cardiac arrests (OHCA) show temporal variations, with most occurring during the day and on Saturdays. This study included all OHCA cases, regardless of cardiopulmonary resuscitation (CPR) attempts, to better understand these patterns.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Temporal variations in out-of-hospital cardiac arrest (OHCA) occurrence are documented.
- Previous studies often exclude cases without cardiopulmonary resuscitation (CPR), potentially skewing findings.
- Understanding OHCA patterns irrespective of CPR is crucial for comprehensive analysis.
Purpose of the Study:
- To investigate temporal variations in OHCA incidence.
- To include all OHCA cases, regardless of CPR status, for a more complete picture.
- To identify potential diurnal, weekly, and monthly patterns in OHCA.
Main Methods:
- Retrospective study of OHCA cases in northern Sweden from 1989-2009.
- Inclusion criteria: individuals aged 25-74 with validated myocardial infarction aetiology (OHCA-V).
- Analysis included all cases, irrespective of whether CPR was performed.
Main Results:
- A daytime excess of OHCA-V was observed, with the highest incidence between 12:00-17:59 (29%) and 06:00-11:59 (27%).
- Saturdays showed the highest weekly incidence (17%).
- January (11%) and December (9%) had the highest monthly incidence.
Conclusions:
- Temporal variations in OHCA-V exist, even when including cases without CPR.
- Unlike some prior studies, no clear morning or Monday peaks were identified.
- Further research with standardized criteria is needed to explore triggers and develop preventive strategies for OHCA.
Objective:
Temporal variations in the occurrence of out-of-hospital cardiac arrest (OHCA) have been shown. Most previous studies have in common that they include individuals whom have received cardiopulmonary resuscitation (CPR) and thus excluding a great number of all the actual cases of OHCA when conducting a study. Therefore the aim of this study was to describe temporal variations of OHCA, regardless of whether CPR was performed or not.
Design:
All individuals aged 25-74 years in northern Sweden, 1989-2009, who suffered an out-of-hospital cardiac arrest with validated myocardial infarction aetiology (OHCA-V), regardless of whether CPR was performed or not, were included in this study, which resulted in 3357 individuals.
Results:
Regarding the diurnal variation, a daytime excess of OHCA-V was seen, with most occurring between 12:00-17:59 (29%) closely followed by the 06:00-11:59 time block (27%). In terms of the weekly variation, most OHCA-V was seen on Saturdays (17%), while January (11%), followed by December (9%), saw the highest incidence of the months.
Conclusion:
A temporal variation in OHCA-V is seen even when including cases where no CPR is attempted. However, this variation differs in some aspects to what some previous studies have shown, in that no clear morning or Monday peaks were seen. In order to explore potential triggers and underlying factors that influence OHCA, more studies like these are needed, preferably following standardized inclusion criteria and definitions of OHCA to better be able to compare results, all in order to develop the best possible preventive strategies.
Related Concept Videos
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
01:19Cardiac Output I:Effect of Heart Rate on Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
01:13The Cardiac Cycle
The Process
Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and...
01:29Cardiac Cycle
During the cardiac cycle, blood flow through the heart is regulated entirely by changing pressure gradients. This sequence of events begins with the heart in a state of total relaxation, known as mid-to-late diastole, during which blood passively flows from...
00:59Hospitals-II
Nurses that work in...
01:30Cardiac Action Potential
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials