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Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States
Out of hospital cardiac arrest (OHCA) remains a leading cause of mortality among adults in the United States. Environmental impact on incidence and outcomes of OHCA has not been fully investigated in recent years. Previous studies showed a possible increase in incidence and mortality in winter seaso...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104224/ https://www.ncbi.nlm.nih.gov/pubmed/33950942 http://dx.doi.org/10.1097/MD.0000000000025643 |
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author | El Sibai, Rayan H. Bachir, Rana H. El Sayed, Mazen J. |
author_facet | El Sibai, Rayan H. Bachir, Rana H. El Sayed, Mazen J. |
author_sort | El Sibai, Rayan H. |
collection | PubMed |
description | Out of hospital cardiac arrest (OHCA) remains a leading cause of mortality among adults in the United States. Environmental impact on incidence and outcomes of OHCA has not been fully investigated in recent years. Previous studies showed a possible increase in incidence and mortality in winter season and during seasons with temperature extremes. This study examines seasonal variation in incidence and outcomes of OHCA in the United States. Retrospective study of adult OHCA using the Nationwide Emergency Department Sample was carried out. Monthly incidence rate per 100,000 ED presentations was calculated. Survival rates for each month of admission were examined by hospital region. Multivariate analyses were conducted to determine the effect of the season and month of admission on survival. A total of 122,870 adult OHCA cases presented to emergency departments (EDs) in 2014 and were included. Average incidence of OHCA cases was 147 per 100,000 ED presentations. Overall survival rate in the study population was 5.6% (95% confidence intervals [CI] = 5.4%–5.9%). Patients had an average age of 65.5 (95% CI: 65.3–65.7) years and were mainly men (61.8%). Rates of OHCA presentations were highest during December and January (9.9% and 10.0%) while survival rates were lowest during December (4.6%) and highest in June (6.9%). Regional variation in OHCA outcomes was also noted with highest average survival rate in West (7.8%) and lowest in South (4.3%). After adjusting for confounders including region of hospital, Summer season (Ref: all other seasons), and more specifically month of June (Ref: all other months) were found to be positively associated with survival (OR 1.27, 95% CI [1.07–1.52], P-value = .008) and (OR 1.43, 95% CI [1.08–1.89], P-value = .012 respectively). Incidence and outcomes of out of hospital cardiac arrest presentations to the emergency departments in the United States have seasonal variation. Both incidence and mortality of OHCA increase during colder months, and survival is significantly higher in summer season or in June. Exploring how to use this variation to improve outcomes through refresher training of medical providers or through other mitigation plans is needed. |
format | Online Article Text |
id | pubmed-8104224 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-81042242021-05-10 Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States El Sibai, Rayan H. Bachir, Rana H. El Sayed, Mazen J. Medicine (Baltimore) 3400 Out of hospital cardiac arrest (OHCA) remains a leading cause of mortality among adults in the United States. Environmental impact on incidence and outcomes of OHCA has not been fully investigated in recent years. Previous studies showed a possible increase in incidence and mortality in winter season and during seasons with temperature extremes. This study examines seasonal variation in incidence and outcomes of OHCA in the United States. Retrospective study of adult OHCA using the Nationwide Emergency Department Sample was carried out. Monthly incidence rate per 100,000 ED presentations was calculated. Survival rates for each month of admission were examined by hospital region. Multivariate analyses were conducted to determine the effect of the season and month of admission on survival. A total of 122,870 adult OHCA cases presented to emergency departments (EDs) in 2014 and were included. Average incidence of OHCA cases was 147 per 100,000 ED presentations. Overall survival rate in the study population was 5.6% (95% confidence intervals [CI] = 5.4%–5.9%). Patients had an average age of 65.5 (95% CI: 65.3–65.7) years and were mainly men (61.8%). Rates of OHCA presentations were highest during December and January (9.9% and 10.0%) while survival rates were lowest during December (4.6%) and highest in June (6.9%). Regional variation in OHCA outcomes was also noted with highest average survival rate in West (7.8%) and lowest in South (4.3%). After adjusting for confounders including region of hospital, Summer season (Ref: all other seasons), and more specifically month of June (Ref: all other months) were found to be positively associated with survival (OR 1.27, 95% CI [1.07–1.52], P-value = .008) and (OR 1.43, 95% CI [1.08–1.89], P-value = .012 respectively). Incidence and outcomes of out of hospital cardiac arrest presentations to the emergency departments in the United States have seasonal variation. Both incidence and mortality of OHCA increase during colder months, and survival is significantly higher in summer season or in June. Exploring how to use this variation to improve outcomes through refresher training of medical providers or through other mitigation plans is needed. Lippincott Williams & Wilkins 2021-05-07 /pmc/articles/PMC8104224/ /pubmed/33950942 http://dx.doi.org/10.1097/MD.0000000000025643 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 3400 El Sibai, Rayan H. Bachir, Rana H. El Sayed, Mazen J. Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States |
title | Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States |
title_full | Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States |
title_fullStr | Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States |
title_full_unstemmed | Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States |
title_short | Seasonal variation in incidence and outcomes of out of hospital cardiac arrest: A retrospective national observational study in the United States |
title_sort | seasonal variation in incidence and outcomes of out of hospital cardiac arrest: a retrospective national observational study in the united states |
topic | 3400 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104224/ https://www.ncbi.nlm.nih.gov/pubmed/33950942 http://dx.doi.org/10.1097/MD.0000000000025643 |
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