title: Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation.
abstract: OBJECTIVE
  Little is known about the factors that influence survival following in-hospital resuscitation, but previous investigations have suggested that in-hospital resuscitations outside of regular working hours are associated with worse survival rates.
  
  
  METHODS
  In-hospital cardiac arrest teams at our hospital were instructed to complete a questionnaire following every emergency call between July 2011 and June 2013. Data on all resuscitation attempts were collected and analyzed.
  
  
  RESULTS
  A total of 65 in-hospital resuscitations were recorded in 42 males (64.6%) and 23 females (35.4%) (mean age 72.0±14.3 years). A total of 54 (83.1%) cardiac arrests were witnessed; seven (10.8%) showed a shockable rhythm at the time of the first ECG. Resuscitation attempts lasted 29.3±41.3 minutes, and 4.1±3.1 mg epinephrine was given. Return of spontaneous circulation could be achieved in 38 patients (58.5%); 29 (44.6%) survived the first day, 23 (35.4%) the seventh day, and 15 patients (23.1%) were discharged alive. Significantly more in-hospital resuscitations were obtained for those performed during non-regular working hours (P<0.001), with higher neuron-specific enolase levels at 72 hours after resuscitation during nonregular working hours (P=0.04). Patients who were discharged alive were significantly younger (P=0.01), presented more often with an initial shockable rhythm (P=0.04), and had a shorter duration of resuscitation (P<0.001) with the need of a lower dose of epinephrine (P<0.001).
  
  
  CONCLUSIONS
  Survival rates following in-hospital resuscitation were poor at any time, but appear to depend less on time-dependent effects of the quality of resuscitation and more on time-dependent effects of recognition of cardiac arrests.
authors: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Herne, Germany.
authors: Martin
authors: M
authors: Christ
authors: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Herne, Germany.
authors: Wolfgang
authors: W
authors: Dierschke
authors: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Herne, Germany.
authors: Katharina Isabel
authors: KI
authors: von Auenmueller
authors: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Herne, Germany.
authors: Marc
authors: M
authors: van Bracht
authors: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Herne, Germany.
authors: Martin
authors: M
authors: Grett
authors: Department of Cardiology and Angiology, Marienhospital Herne, Ruhr - University Bochum, Herne, Germany.
authors: Hans-Joachim
authors: HJ
authors: Trappe
keywords: emergency medicine; sudden cardiac death; time of day