Out of hospital cardiac arrest outcomes: Impact of weekdays vs weekends admission on survival to hospital discharge

Abstract

Background: Cardiac arrests are a leading cause of mortality with survival of only 12%. In the United States, cardiac arrests were significantly more likely to occur on Saturdays. Hospitals experience a decrease in staffing on weekends. This study aims to assess the relationship between weekend vs weekday admission and outcomes of patients presenting with out of hospital cardiac arrests (OHCA) in the United States. Methods: This retrospective study utilized the 2014 US National Emergency Department Sample (NEDS) database. Patients who sustained out of hospital cardiac arrests were included using ICD-9-CM codes. Descriptive analysis was conducted, followed by bivariate analysis to compare the collected variables by admission day. Multivariate analysis was done to assess the impact of weekday vs weekend admission on survival of cardiac arrests patients after adjusting for confounders. Results: A total of 145,774 patients with cardiac arrest were included in this study. Mean age was 65.9 years with male predominance of 61.8%. Almost 71% of cardiac arrests took place on a weekday. As an overall outcome, only 5.7% patients survived to hospital discharge. After adjusting for significant confounders, patients presenting on weekends were less likely to survive compared to those admitted on weekdays (OR = 0.833, 95% CI: 0.727–0.954). Conclusion: In this study, patients with OHCA admitted to the ED on weekends had slightly lower survival compared to those admitted on weekdays. Modifiable factors should be identified in future studies to reduce outcome discrepancies and improve survival in this patient population. © 2019 Elsevier B.V.