Identification of a morning out-of-hospital cardiac arrest cluster of high-incidence: towards a chrono-preventive care strategy.
chrono-prevention
circadian rhythm
epidemiology
out-of-hospital cardiac arrest
registry
temporal incidence cluster
Journal
Journal of evaluation in clinical practice
ISSN: 1365-2753
Titre abrégé: J Eval Clin Pract
Pays: England
ID NLM: 9609066
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
15
11
2019
revised:
05
03
2020
accepted:
06
03
2020
pubmed:
27
3
2020
medline:
29
7
2021
entrez:
27
3
2020
Statut:
ppublish
Résumé
The human body is regulated by intrinsic factors which follow a 24-hour biological clock. Implications of a circadian rhythm in the out-of-hospital cardiac arrest (OHCA) are studied but the literature is not consistent. The main objective of our study was to identify temporal cluster of high or low incidence of OHCA occurrence during a day. Multicentre comparative study based on the French national OHCA registry data between 2013 and 2017. After describing the population, the detection of significant temporal clusters of OHCA incidence was achieved using temporal scan statistics based on a Poisson model adjusted for age and gender. Then, comparisons between identified patients clusters and the rest of the population were performed. During the study, 37 163 medical OHCA victims were included. The temporal scan revealed a significant 3-hour high incidence temporal cluster between 8:00 am and 10:59 am (Relative R = 1.76, P < .001). In the identified cluster, OHCA occurred more out of the home with fewer witnesses, and advanced life support was less attempted in the cluster. No difference was observed on the return of spontaneous circulation, survival at hospital admission, and survival 30 days after the OHCA or at hospital discharge. We observed a three-hour morning high incidence peak of OHCA. This high incidence could be explained by different physiological changes in the morning. These changes are well known and the evidence of a morning peak of cardiovascular disease should enable medical teams to adapt care strategy and hospital organization.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
84-92Informations de copyright
© 2020 John Wiley & Sons, Ltd.
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