If you're going to go into cardiac arrest, a hospital is probably the best place to do it. But even then, the odds of survival vary dramatically based on when it takes place, according to a new study published in BMJ Quality and Safety.
Emily Robinson, of the Intensive Care National Audit & Research Centre in London, and colleagues looked at 27,700 records from the U.K.'s National Cardiac Arrest Audit. The researchers found that survival rates for in-hospital cardiac arrest were considerably worse at nights and during weekends, even after adjusting for other factors. The group also analyzed how often patients were returned to spontaneous circulation for greater than 20 minutes (ROSC), and found a similar drop-off in success during off hours.
Those lower success rates, the authors wrote, were due to differences in care.
One possible explanation: fewer nurses working at night. That means delayed recognition of the problem and slower reaction times.
"In the case of medical staff, there is also often a paucity of experienced senior staff immediately available on site, which may influence decision-making before, during, and if successful after, a cardiac arrest," the authors wrote.
The chart below shows crude outcome percentages for survival and return to spontaneous circulation for more than 20 minutes in each of the three time periods analyzed.