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Infant out-of-hospital cardiac arrest during nights and weekends

Aditya C Shekhar1, Molly K Childers2, Ethan E Abbott1

  • 1Icahn School of Medicine at Mount Sinai, New York City, NY, United States of America.

The American Journal of Emergency Medicine
|May 15, 2024
PubMed

Insights

Infant cardiac arrest survival rates, measured by return of spontaneous circulation (ROSC), are lower on weekends compared to weekdays. This finding highlights a potential disparity in emergency medical services (EMS) care timing.

Area of Science:

  • Pediatric Emergency Medicine
  • Public Health
  • Cardiology

Background:

  • Adult cardiac arrest outcomes are worse during nights and weekends.
  • Research on time-based disparities in infant cardiac arrest outcomes is lacking.
  • This study addresses the gap in understanding temporal variations in infant cardiac arrest care.

Purpose of the Study:

  • To investigate if infant out-of-hospital cardiac arrest outcomes differ based on time of day or day of the week.
  • To compare return of spontaneous circulation (ROSC) rates in infants experiencing cardiac arrest during daytime vs. nighttime and weekdays vs. weekends.

Main Methods:

  • Utilized the National Emergency Medical Services Information System (NEMSIS) database (January 2021 - December 2022).
  • Included infant out-of-hospital cardiac arrests (<1 year old) prior to emergency medical services (EMS) arrival.
  • Compared ROSC achievement rates between daytime (0800-1959) and nighttime (2000-0759), and between weekdays and weekends (Saturday/Sunday).

Main Results:

  • Analyzed 8549 infant cardiac arrests.
  • ROSC rates were significantly lower on weekends (14.1%) compared to weekdays (16.8%) (p=0.00097).
  • A non-significant trend of lower ROSC rates during nighttime (15.3%) versus daytime (16.4%) was observed (p=0.08076).

Conclusions:

  • Infant out-of-hospital cardiac arrest ROSC rates are significantly lower on weekends compared to weekdays.
  • Further research and quality improvement initiatives are necessary to address this weekend disparity.
  • Understanding and mitigating time-based variations in emergency care is crucial for improving infant cardiac arrest outcomes.
Abstract

Keywords:
Cardiac arrestInfantNighttimeOut-of-hospital cardiac arrestOutcomes

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