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J Korean Soc Emerg Med > Volume 33(1); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(1): 28-36.
일중 시간에 따른 병원 밖 심정지 예후: 도시전체 다기관 후향적 관찰연구
류종화1, 김정호1 , 류현욱2 , 김종연3 , 안재윤2 , 문성배2 , 이동언2 , 장태창4 , 진상찬5 , 문유호1
1영남대학교병원 응급의학과
2경북대학교 의과대학 응급의학교실
3경북대학교병원 공공보건의료사업실
4대구가톨릭대학교 의과대학 응급의학교실
5계명대학교 동산의료원 응급의학과
Out-of-hospital cardiac arrest outcomes according to the time of day: a citywide multicenter retrospective observational study
Jong Hwa Ryu1, Jung Ho Kim1 , Hyun Wook Ryoo2 , Jong-yeon Kim3 , Jae Yun Ahn2 , Sungbae Moon2 , Dong Eun Lee2 , Tae Chang Jang4 , Sang Chan Jin5 , You Ho Mun1
1Department of Emergency Medicine, Yeungnam University School of Medicine and College of Medicine, Daegu, Korea
2Department of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
3Department of Public Health, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
4Department of Emergency Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
5Department of Emergency Medicine, Dongsan Medical Center, Keimyung School of Medicine, Daegu, Korea
Correspondence  Jung Ho Kim ,Tel: 053-620-3191, Fax: 053-623-8030, Email: jhkimem@naver.com,
Received: May 23, 2021; Revised: July 22, 2021   Accepted: August 9, 2021.  Published online: February 28, 2022.
ABSTRACT
Objective:
The characteristics and prognosis of out-of-hospital cardiac arrest (OHCA) patients can vary due to a variety of factors, including the time of the day. We tried to identify the characteristics and prognosis of OHCA in a Korean metro city based on the time of the day.
Method:
This citywide retrospective observational study was conducted from January 1, 2015, to November 31, 2020, in Daegu, Korea on patients over 18 years of age who were suspected of having a medical etiology of OHCA. We evaluated the characteristics and outcomes of OHCA, according to the time of day, divided into dawn (00:00-05:59), morning (06:00-11:59), afternoon (12:00-17:59), and night (18:00-23:59). The outcome variables were survival to hospital discharge and favorable neurological outcomes.
Results:
The median age of the total of 4,783 OHCA patients in the study was 72.0 years of which 3,096 (64.7%) were males. The number of patients who survived was 317 (7.8%) and 301 (6.3%) were discharged with favorable neurological outcomes. There were 672 (14.0%) patients admitted at dawn, 1,607 (33.6%) in the morning, 1,379 (28.8%) in the afternoon, and 1,125 (23.5%) at night. After adjusting for the possible confounding variables, compared with the morning group, the survival to hospital discharge was low in the afternoon and the night (adjusted odds ratio [aOR], 0.69; 95% confidence interval [CI], 0.48-0.98 and aOR, 0.48; 95% CI, 0.32-0.74). In addition, favorable neurological outcomes were also low in the afternoon and the night compared with the morning (aOR, 0.59; 95% CI, 0.40-0.85 and aOR, 0.62; 95% CI, 0.41-0.93).
Conclusion:
Diurnal differences in OHCA outcomes were observed. Identification of the diurnal OHCA characteristics will be necessary to devise an appropriate regional emergency medical services strategy.
Key words: Diurnal variation; Out-of-hospital cardiac arrest; Outcomes; Resuscitation; Time
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