Hospitalized Patients Who Go Into Cardiac Arrest After 11 P.M. More Likely To Die, Study Finds

Hospitalized patients who experience cardiac arrest at night or on weekends are less likely to survive than patients whose hearts stop during other hospital shifts, according to a study published Wednesday in the Journal of the American Medical Association, the Richmond Times-Dispatch reports. For the study, researchers examined the records of 86,748 patients included in the National Registry of CardioPulmonary Resuscitation, a database sponsored by the American Heart Association that contains information from more than 500 hospitals. The study defined night as between 11 p.m. and 6:59 a.m., and day was defined as 7 a.m. to 10:59 p.m. The weekend was defined as 11 p.m. on Friday to 6:59 a.m. on Monday (Smith, Richmond Times-Dispatch, 2/20). A total of 58,593 cardiac arrests occurred during the day/evening, and a total of 28,155 cardiac arrests occurred during the night.

The study found that, after accounting for other factors, patients' chances of surviving a nighttime cardiac arrest were 18% lower compared with those who experienced cardiac arrest during the day/evening (Johnson, AP/Long Island Newsday, 2/19). Of the patients who experienced cardiac arrest during the day/evening, about one in five survived to go home, compared with about one in seven patients who experienced a cardiac arrest during the nighttime (Richmond Times-Dispatch, 2/20). In addition, weekend survival rates were lower than those on weekdays, but the difference was less pronounced than the day-night disparity, according to researchers (AP/Long Island Newsday, 2/19). There was no disparity in survival rates among patients treated in emergency departments.

Mary Ann Peberdy, an associate professor of medicine at Virginia Commonwealth University and lead author of the study, said, "Survival at night is clearly lower than during the day." She said, "We know hospitals are staffed differently at night," adding, "There are not as many people around." Peberdy said, "Nurses and doctors are less likely to be walking in and out of patients' rooms looking at them." She said that patients should not be concerned about being admitted to hospitals because "[s]urvival from cardiac arrest in the hospital has remained stagnant for the last 30 years" (Richmond Times-Dispatch, 2/20).

Peberdy said, "Our findings should be a pretty big wakeup call to urge hospitals to critically evaluate how they are performing resuscitation," adding, "It may well be possible that there is a less effective and less efficient response at night" (AP/Long Island Newsday, 2/19).

An abstract of the study is available online.