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Impact of in or out of office hours at admission time on outcome in out-of-hospital cardiac arrest patients

Genbrugge, Corneliaa,b,*; Viaene, Elsc,*; Meex, Ingrida,b; De Vadder, Katrienc; Eertmans, Warda,b; Boer, Willemb; Jans, Franka,b; De Deyne, Cathyb; Dens, Jod; Ferdinande, Bertd

European Journal of Emergency Medicine: August 2017 - Volume 24 - Issue 4 - p 249–254
doi: 10.1097/MEJ.0000000000000343
ORIGINAL ARTICLES
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Background In out-of-hospital cardiac arrest (OHCA), neurological outcome is determined by the severity of neurological injury, early percutaneous coronary intervention, and application of neuroprotective temperature management. As this is a very time-intensive and manpower-intensive protocol, we hypothesized that there would be a difference in outcome between OHCA patients admitted during and out of office hours.

Methods We prospectively collected demographic data of OHCA patients in two hospitals. All patients included were treated at 33°C for 24 h, followed by a rewarming phase until 36.6°C. During office hours were defined as arriving between 8:00 a.m. and 5:00 p.m. on weekdays. Neurological outcome at 180 days was assessed following the Cerebral Performance Category scale.

Results Forty-seven (31%) patients were admitted during office hours and 105 (69%) out of office hours (P=0.199). Patients admitted during office hours were significantly older, respectively, 66±14 and 59±15 years (P=0.014). There was no significant difference between both groups in the number of patients who underwent coronary angiography, door to angiography time, and number of affected vessels. The median time spent in the target range of PaO2, PaCO2, and lactate was also not significantly different. We found no significant difference in survival until 180 days between both groups (P=0.599), even after adjustment for age (95% confidence interval: 0.44–1.90, hazard ratio: 0.912).

Conclusion Survival until 180 days between OHCA patients admitted during office hours or out of office hours was not significantly different in two hospitals with a fixed protocol for neuroprotection and 24/7 streamlined access to coronary angiography.

aFaculty of Medicine and Life Sciences, Hasselt University, Hasselt

bDepartment of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Genk

cDepartment of Cardiology, University Hospitals Leuven, Leuven

dDepartment of Cardiology, Ziekenhuis Oost-Limburg Genk, Genk, Belgium

* Cornelia Genbrugge and Els Viaene contributed equally to the writing of this article.

Correspondence to Cornelia Genbrugge, MD, Ziekenhuis Oost-Limburg, Hasselt University, Schiepse Bos 6, 3600 Genk, Belgium Tel: +32 8932 5359; fax: +32 8957 9875; e-mail: cornelia.genbrugge@uhasselt.be

Received June 16, 2015

Accepted October 5, 2015

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