Association of Nights and Weekends with Survival of Traumatic Out-of-Hospital Cardiac Arrest following Traffic Collisions: Japanese Registry-Based Study

Tatsuma Fukuda, Naoko Ohashi-Fukuda, Hiroshi Sekiguchi, Ryota Inokuchi and Ichiro Kukita
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Tatsuma Fukuda: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
Naoko Ohashi-Fukuda: Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
Hiroshi Sekiguchi: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
Ryota Inokuchi: Department of Health Services Research, University of Tsukuba, Ibaraki 305-8575, Japan
Ichiro Kukita: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan

IJERPH, 2021, vol. 18, issue 23, 1-12

Abstract: Background: The process of care for traumatic out-of-hospital cardiac arrest (OHCA) may be different at night and on the weekend. However, little is known about whether the rate of survival after OHCA is affected by the time of day and day of the week. Methods: This observational study analyzed the Japanese government-led nationwide population-based registry data of OHCA patients. Patients who experienced traumatic OHCA following traffic collisions from 2013 to 2017 were included in the study. A multivariable logistic regression model was used to examine the association of both time of day (day/evening vs. night) and day of the week (weekday vs. weekend) with outcomes after traumatic OHCA. Night was defined as 23:00 p.m. to 6:59 a.m., and weekends were defined as Saturday and Sunday. The primary outcome was one-month survival. Results: A total of 8500 patients (mean [SD] age, 57.7 [22.3] years; 68.6% male) were included. 2267 events (26.7%) occurred at night, and 2482 events (29.2%) occurred on weekends. Overall, 173 patients (2.0%) survived one month after OHCA. After adjusting for potential confounders, one-month survival during the day/evening (148/6233 [2.4%]) was significantly higher than during the night (25/2267 [1.1%]) (adjusted OR, 1.95 [95%CI, 1.24–3.07]), whereas there was no significant difference in one-month survival between weekdays (121/6018 [2.0%]) and weekends (52/2482 [2.1%]) (adjusted OR, 0.97 [95%CI, 0.69–1.38]). Conclusions: One-month survival after traumatic OHCA was significantly lower during the night than during the day/evening, although there was no difference in one-month survival between weekdays and weekends. Further studies are warranted to investigate the underlying mechanisms of decreased survival at night.

Keywords: out-of-hospital cardiac arrest; cardiopulmonary resuscitation; trauma; off-duty hours; health care system; work style reform (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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