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Influence of day-night and weekday-weekend differences on rapid response team performance in in-hospital cardiac
Edson Luiz Fávero Junior1, Felipe Antonio Rischini1, Thiago Dias Baumgratz1
1Universidade Estadual Paulista, Medical School, Department of Internal Medicine - (SP), Brazil.
Objective:
The aim of this study was to compare the return of spontaneous circulation and survival to discharge of patients who experienced in-hospital cardiac arrest assisted by a rapid response team during the day versus night and weekdays versus weekends.
Methods:
This retrospective observational study was conducted at a tertiary teaching hospital. Patients aged 18 years or older who experienced a cardiac arrest in the wards between March 2018 and December 2021 were included. Patients with an express order of "natural death permission" were excluded. Data regarding the period of in-hospital cardiac arrest occurrence, return of spontaneous circulation, and survival to discharge were collected from medical records. In addition, data related to nursing staff leave were collected.
Results:
A total of 387 patients were included in the analysis. The mean age was 65.4±14.8 years, and 53.7% were men. In the multivariate logistic regression, in-hospital cardiac arrest during the day versus night was not associated with return of spontaneous circulation. However, in-hospital cardiac arrest during weekdays versus weekends showed a significant association with return of spontaneous circulation (odds ratio=2.073; 95%CI 1.206-3.564; p=0.008). No differences were found in survival to discharge between daytime versus nighttime or weekdays versus weekends.
Conclusion:
There is no difference in return of spontaneous circulation rates between in-hospital cardiac arrest events occurring during the day versus night. However, a significant difference in return of spontaneous circulation rates was observed between weekdays and weekends, although this difference did not extend to in-hospital survival rates.
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