Patients Most Likely to Die of Cardiac Arrest During Weeknights & Weekends, Study Finds

By Mia Garchitorena
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Many researchers have analyzed and compared in-hospital survival rates during weekdays, weeknights and weekends. A number of studies have found an association between lower survival rates during weeknights and weekends, and the medical community has dubbed this phenomenon as the “weekend effect”.

A new study finds that patients who go into in-hospital cardiac arrest (IHCA) during the weekend have a lower chance of survival compared to those who are admitted to the hospital during a weekday.

Researchers at the Geisinger Health System in Pennsylvania sought to determine trends in survival differences in IHCA between on-hours and off-hours. On-hours, or weekdays, were defined as Monday to Friday between 7:00 AM to 10:59 PM while off-hours, or weeknights and weekends, were defined as Monday to Friday 11:00 PM to 6:59 AM and all day Saturday and Sunday. The study was published in the Journal of the American College of Cardiology.

The researchers analyzed data on more than 151,071 adults from the “Get with the Guidelines –Resuscitation registry” at 470 hospitals in the United States between 2000 and 2014 and examined survival trends in IHCA during on-hours and off-hours.

They found that 52.4% out of the 151,071 patients had an IHCA during off-hours. Risk-adjusted survival rates improved over time in both groups: Patients who had an IHCA during weekdays increased from 16% to 25.2% between 2000 and 2014 while the survival rates at hospitals during weeknights and weekends increased from 11.9% to 21.9%, according to the study.

Trends in Survival for In-Hospital Cardiac Arrests During On-Hours & Off-Hours. (Source: JACC)

“Despite an overall improvement in survival, lower survival in IHCA during off-hours compared with on-hours persists,” the authors wrote.

A 2015 international study published in BMJ Quality & Safety found that patients in several countries who are admitted to hospitals on Saturdays and Sunday are more likely to die within 30 days than patients who are hospitalized during the week.

The reasons for this phenomenon are unknown due to “limitations of administrative datasets”, but the researchers stressed that this global trend calls for a need for further investigation into the factors that play into the “weekend effect”.

Richard Lilford, professor at Warwick Medical School, and Yen-Fu Chen, principal research fellow at Warwick Medical School in England, cited several of the study’s limitations in accompanying editorial commentary published in BMJ. They stated that the study only analyzed a small portion of hospitals in several countries, which could make the data “misleading” and misrepresentative of an international trend.

They provided several strategies to find out why the “weekend effect” happens: Examine more detailed analyses of databases, conduct direct examination of quality of care during weekdays and over weekends, analyze disease-specific and intervention studies.

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