Vol 5, No 2 (2020)
Original article
Published online: 2020-06-15

open access

Page views 472
Article views/downloads 559
Get Citation

Connect on Social Media

Connect on Social Media

Observational, retrospective analysis of the circadian variability of out-of-hospital cardiac arrest within days of the week

Stanisław Szczerbiński
Medical Research Journal 2020;5(2):68-71.

Abstract

Introduction

Previous studies showed a significant difference in out-of-hospital cardiac arrest (OHCA) occurrence between days of the week, with its highest incidence from Saturday to Monday and lowest in the middle of the week (Tuesday to Friday). The aim of this study was to compare the diurnal variability of the occurrence of OHCA on the days  with the highest and lowest incidence of the latter.

Methods

Retrospective analysis of 815 OHCA cases with presumed cardiac etiology in Opole (Poland), covering a 2-year period (2006-2007). Statistical evaluation of the circadian patterns of OHCA occurrence on days with the highest and the lowest OHCA prevalence.

Results

Circadian variability of OHCA incidence, assessed by comparing consecutive 3-hour intervals, was present on Saturday to Monday (p=0.04), but absent on Tuesday to Friday (p=0.08). Both analyzed periods differed in terms of the morning (09:00-11:00) peak of OHCA occurrence, which was clearly seen on Saturday-Monday, but absent in the mid-week (median 8.0 [7.0-10.0] vs 5.0 [5.0-6.5], p=0.03).

Conclusions

The occurrence of OHCA follows different patterns on Saturday to Monday versus the mid-week days, with a pronounced morning peak only on Saturday to Monday.

Article available in PDF format

View PDF Download PDF file

References

  1. Kubica A, Szczerbiński S, Kieszkowska M, et al. Wpływ czynników klimatycznych i chronologicznych na występowanie ostrych incydentów chorobowych. Folia Cardiol. 2014; 3: 263–266.
  2. Hayashi S, Toyoshima H, Tanabe N, et al. Daily peaks in the incidence of sudden cardiac death and fatal stroke in Niigata Prefecture. Jpn Circ J. 1996; 60(4): 193–200.
  3. Herlitz J, Eek M, Holmberg M, et al. Diurnal, weekly and seasonal rhythm of out of hospital cardiac arrest in Sweden. Resuscitation. 2002; 54(2): 133–138.
  4. Klimczuk T, Kubica J, Kasprzak M, et al. Łagodna hipotermia terapeutyczna po nagłym zatrzymaniu krążenia w przebiegu ostrego zespołu wieńcowego – doświadczenia z wdrażania metody. Folia Cardiologica. 2015; 10(1): 19–24.
  5. Ratajczak J, Łach P, Szczerbiński S, et al. Atmospheric conditions and the occurrence of out-of-hospital cardiac arrest in Poland — preliminary analysis of poorly understood phenomena. Medical Research Journal. 2018; 3(3): 121–126.
  6. Szczerbinski S, Ratajczak J, Lach P, et al. Epidemiology and chronobiology of out-of-hospital cardiac arrest in a subpopulation of southern Poland: A two-year observation. Cardiol J. 2020; 27(1): 16–24.
  7. Karlsson LIM, Wissenberg M, Fosbøl EL, et al. Diurnal variations in incidence and outcome of out-of-hospital cardiac arrest including prior comorbidity and pharmacotherapy: a nationwide study in Denmark. Resuscitation. 2014; 85(9): 1161–1168.
  8. Soo LH, Gray D, Young T, et al. Circadian variation in witnessed out of hospital cardiac arrest. Heart. 2000; 84(4): 370–376.
  9. Peckova M, Fahrenbruch CE, Cobb LA, et al. Circadian variations in the occurrence of cardiac arrests: initial and repeat episodes. Circulation. 1998; 98(1): 31–39.
  10. Hermida RC, Ayala DE, Portaluppi F. Circadian variation of blood pressure: the basis for the chronotherapy of hypertension. Adv Drug Deliv Rev. 2007; 59(9-10): 904–922.
  11. Rudic RD. Time is of the essence: vascular implications of the circadian clock. Circulation. 2009; 120(17): 1714–1721.
  12. Tofler GH, Brezinski D, Schafer AI, et al. Concurrent morning increase in platelet aggregability and the risk of myocardial infarction and sudden cardiac death. N Engl J Med. 1987; 316(24): 1514–1518.
  13. Nicolau GY, Haus E, Popescu M, et al. Circadian, weekly, and seasonal variations in cardiac mortality, blood pressure, and catecholamine excretion. Chronobiol Int. 1991; 8(2): 149–159.
  14. Ong MEh, Ng FSp, Yap S, et al. Temporal variation of out-of-hospital cardiac arrests in an equatorial climate. Open Access Emerg Med. 2010; 2: 37–43.
  15. Gach D, Nowak JU, Krzych ŁJ. Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis. Kardiol Pol. 2016; 74(10): 1180–1187.
  16. Umińska JM, Buszko K, Ratajczak J, et al. Comparison of temperature measurements in esophagus and urinary bladder in comatose patients after cardiac arrest undergoing mild therapeutic hypothermia. Cardiol J. 2018 [Epub ahead of print].
  17. Kozinski M, Pstragowski K, Kubica JM, et al. ACS network-based implementation of therapeutic hypothermia for the treatment of comatose out-of-hospital cardiac arrest survivors improves clinical outcomes: the first European experience. Scand J Trauma Resusc Emerg Med. 2013; 21: 22.
  18. Nadolny K, Bujak K, Kucap M, et al. The Silesian Registry of Out-of-Hospital Cardiac Arrest: Study design and results of a three-month pilot study. Cardiol J. 2018 [Epub ahead of print].