PURPOSE: Population and pre-hospital studies of acute ischemic events or sudden cardiac death consistently report diurnal, daily, monthly and seasonal variations in incidence. However, these variables have not been sufficiently studied among in-hospital patients. Some in-hospital studies, limited in scope and scale, have found diurnal variation in resuscitation frequency but daily, monthly and seasonal variation of in-hospital resuscitations have not been studied. Our objective is to assess in-hospital resuscitation data for daily, monthly and seasonal variation and its impact on survival.
METHODS: We utilized a registry from the Medical Center of Central Georgia, Macon, Georgia and analyzed 4638 attempted resuscitations between January 1, 1987 and December 31, 2000. Only the first resuscitation attempt for each admission was analyzed.
RESULTS: Significant differences in frequency of resuscitation attempts were found by day of the week ( χ2(6) = 18.5, p = 0.0052), weekday versus weekend ( χ2(1) =15.8, p<0.001), month of the year ( χ2(11) = 42.2, p<0.0001), and season (χ2(3) = 26.9, p<0.0001). Although not part of the original study design, hospital census data from 1993 to 2000 were used to create rates of resuscitation. Once the frequencies from 1993 to 2000 were converted to rates, no significant variations were found in any of the variables tested. Likelihood of survival to discharge did not vary by day, month or season.
CONCLUSION: We found significant variation in day of the week, weekday versus weekend, month of the year and season of in-hospital resuscitation frequency. However, once corrected for hospital census, in stark contrast to community studies, this variation became non-significant. These differences may be due to the disparity in population and environmental factors between hospitalized and non-hospitalized patients. Likelihood of survival did not demonstrate significant variation.
CLINICAL IMPLICATIONS: Use of census in resuscitation studies may change the outcome. No daily, monthly or seasonal variations exist in in-patient resuscitation and thus resuscitation resources need not be distributed according to these variables.
DISCLOSURE: Karan Julka, No Financial Disclosure Information; No Product/Research Disclosure Information