Study Suggests No 'Weekend Effect' for Cardiac Arrest Patients

Peter Russell

June 03, 2019

People admitted to hospital with a cardiac arrest over the weekend do not face a higher mortality risk compared with those admitted during the week, according to new findings.

A study suggested that the presence of round-the-clock cardiac arrest teams may play a crucial role.

The research, presented as an abstract at the British Cardiovascular Society conference (BCS) in Manchester, looked at 5 year survival for people being treated in an NHS hospital for cardiac arrest.

Weekend Effect 'Not a Blanket Phenomenon'

Evidence suggesting a so-called 'weekend effect', with elevated mortality rates for patients admitted to hospital at the weekend, has been hotly debated.

"We have noted in the past couple of years – not only from our group but also from other groups – that the weekend effect is not a blanket phenomenon," explained Dr Rahul Potluri, founder of the Algorithm for Comorbidities, Associations, Length of Stay & Mortality (ACALM) study unit at Aston University, who led the research. "It doesn't affect all patients with all conditions. And research is happening into targeted areas where it does exist and where it doesn't.

"So, we wanted to look at the sickest of patients – ie, the patients who come into hospital with a cardiac arrest, and whether there's a weekend effect affecting these patients."

Anonymous information on patients admitted to hospital with a cardiac arrest was obtained from several hospitals in England between 1st January 2000 and 30th June 2014.

The majority (81%) were admitted on weekdays.

The results were adjusted to account for external factors which could influence death rates, such as age, gender, ethnic group, and the top 10 most common causes of mortality in the UK.

This study followed on from work previously presented at the BCS conference suggesting that there was a weekend effect in people going to hospital with heart failure or atrial fibrillation.

However, the researchers concluded that no weekend effect was demonstrated in patients presenting to hospital with cardiac arrests.

Role of Cardiac Arrest Teams

The researchers said the presence of 24/7 cardiac arrest teams in acute hospitals may explain their findings.

"It should also be quite reassuring to the public, and to physicians, that the sickest of the sick patients are getting adequate treatment when they come into hospital," Dr Potluri told Medscape News UK .

Dr Shajil Chalil, consultant cardiologist at Blackpool Teaching Hospitals NHS Foundation Trust, and study co-author, said: "You can’t choose when you're struck down by a devastating cardiac arrest. But our research potentially highlights the major value of cardiac arrest teams in hospitals set up to ensure optimal care for these heart patients every minute of every day."

Prof Metin Avkiran, associate medical director at the British Heart Foundation said: "This is a success story, and shows the life-saving importance of specialist teams working in the NHS. A cardiac arrest is a medical emergency and statistics show that for every minute that passes without CPR and defibrillation, a person’s chance of survival decreases by around 10%."

British Cardiovascular Society, Manchester/BMJ/Heart. Cardiac arrest patients presenting to hospitals at weekends are not subject to the weekend effect: insights from the ACALM big data, United Kingdom, Potluri R et al.  Abstract.

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