(February 19, 2008 - Insidermedicine) Patient outcomes, most notably survival to discharge, are better for those who experience an in-hospital cardiac arrest during the day on a weekday compared with those who experience one at night or on a weekend, according to a study published in the Journal of the American Medical Association.

Here are some strategies for preventing in-hospital cardiac arrest from the United Kingdom Resuscitation Council:

•    Place critically ill patients, or those at risk for clinical deterioration, in areas where the level of care is matched to the level of patient sickness.

•    Regularly monitor such patients using simple vital sign observation (e.g., pulse, blood pressure, respiratory rate). Match the frequency and type of observations to the severity of the illness of the patient.

•    Use an Early Warning Sign (EWS) system to identify patients who are critically ill, at risk of clinical deterioration or cardiopulmonary arrest, or both.

Researchers from Virginia Commonwealth University collected data on recovery from in-hospital cardiac arrests using data from the American Heart Association’s National Registry of Cardiopulmonary Resuscitation. This included data collected between 2000 and 2007 on over 86,000 adult cardiac arrests occurring in 507 hospitals.

In those who experienced a cardiac arrest, the rate of survival to discharge was 14.7% for those occurring during the night, compared with 19.8% for those occurring during the day or evening. Survival for those experiencing an arrest during the day or evening on a weekday was 20.6%, substantially higher than the 17.4% survival rate experienced by those who had an arrest during the day or evening on a weekend.

Today’s research highlights the impact of the time of day and day of the week on survival rates for in-hospital cardiac arrests. These differences may be due to hospital process and/or biological factors and could possibly be corrected with improvements in evening and weekend hospital resuscitation processes.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.