Comparison of Circadian Variation for In-Hospital Versus Out-of-Hospital Sudden Cardiac Arrest Survivors
| Autor: | Aditya Bhonsale, Samir Saba, Yicheng Tang, Sandeep Jain, Nathan Anthony Mark Estes, Tarryn Tertulien, Krishna Kancharla |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Patient demographics Comorbidity Ventricular Flutter Age Distribution Internal medicine Atrial Fibrillation medicine Humans In patient Survivors Circadian rhythm Renal Insufficiency Chronic Aged Out of hospital business.industry Sudden cardiac arrest Length of Stay Middle Aged Circadian Rhythm Heart Arrest Large cohort Death Sudden Cardiac Ventricular Fibrillation Tachycardia Ventricular Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest |
| Zdroj: | The American Journal of Cardiology. 160:1-7 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2021.08.034 |
| Popis: | Several studies have reported circadian periodicity of sudden cardiac arrest (SCA). It remains unclear to what extent this circadian rhythm is influenced by variation in patients' activities. One way to elucidate this is to compare patients with out-of-hospital cardiac arrests (OHCAs) with those with in-hospital cardiac arrests (IHCAs). We therefore examined the presence of a circadian pattern of SCA in a large cohort of OHCA and IHCA survivors. A total of 1,433 consecutive survivors of SCA in the Pittsburgh area from 2002 to 2012 were included. Patient demographics, including clinical histories and details of SCA, were collected. The distribution of SCA throughout the day was tested for differences using the chi-square test. Of the 1,224 patients analyzed, 706 had IHCA and 518 OHCA. We observed a nadir of SCA in the nighttime hours between 12 a.m. and 6 a.m. in both IHCA and OHCA groups (p0.001), although this pattern was more blunted in the IHCA group. Patients who had an SCA in the nighttime window had more co-morbidities (p = 0.01). The circadian pattern was noted to be absent in patients with higher co-morbidity burden in IHCA only. In conclusion, the typical pattern of nighttime nadir in SCA is observed in patients with both OHCA and IHCA but is blunted in the hospital and especially in sicker patients. This suggests a common mechanistic pathway of SCA transcending differences in physical activities of patients and a difference in how co-morbidities interact with the timing of SCA in the inpatient setting. |
| Databáze: | OpenAIRE |
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