Kids With Cardiac Arrest Less Likely to Survive CPR at Night

Researchers don't yet know why chances of success better at other times of day

By Randy Dotinga

Tuesday, November 8, 2016

TUESDAY, Nov. 8, 2016 (HealthDay News) -- Hospitalized children who have suffered cardiac arrest have lower chances of surviving when CPR is performed on them at night than at other times of the day, a new study finds.

The finding is similar to what has been seen in studies of adult hospital patients, the researchers said.

The authors of the new study called the lower nighttime survival rates "an important, yet under-recognized public health concern."

Researchers reviewed an American Heart Association database of cardiac arrests in hospitals. Cardiac arrest is when the heartbeat stops abruptly, usually caused by an abnormality in the heart's electrical system.

The study was led by Dr. Farhan Bhanji, a pediatric critical care specialist at McGill University and Montreal Children's Hospital in Canada. He and his colleagues tracked more than 12,000 children (mostly male) at 354 hospitals. The young patients received CPR for at least two minutes after their hearts stopped from cardiac arrest.

Close to 8,600 of the children had CPR during the day or evening. The rest required CPR at night.

After adjusting for factors that could skew their findings, the researchers found that kids who had CPR at night were 12 percent less likely to survive.

Bhanji's team found no difference in weekday and weekend death rates. "Although the absolute rate of survival to hospital discharge was lower on weekends than weekdays, this difference did not reach statistical significance when adjusted for confounding factors," they wrote.

It's not clear why children who undergo CPR at night are less likely to survive. The researchers estimated that almost 300 children a year could be saved in the United States if the overall survival rate (36 percent) rose to the daytime level (41 percent).

"These findings may have important implications for hospital staffing, training and resource allocation," the study authors wrote. "Discrepancy between daytime and nighttime outcomes represents an important patient safety concern that warrants further investigation."

The study was published online Nov. 7 in the journal JAMA Pediatrics.

SOURCES: American Medical Association, press release, Nov. 7, 2016; JAMA Pediatrics, Nov. 7, 2016

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