title: Survival After Extracorporeal Cardiopulmonary Resuscitation on Weekends in Comparison With Weekdays.
abstract: BACKGROUND
  Extracorporeal cardiopulmonary resuscitation (ECPR) requires urgent decision-making and high-quality skills, which may not be uniformly available throughout the week. Few data exist on the outcomes of patients with cardiac arrest who receive in-hospital ECPR on the weekday versus weekend. Therefore, we investigated whether the outcome differed when patients with in-hospital cardiac arrest received ECPR during the weekend compared with a weekday.
  
  
  METHODS
  Two hundred patients underwent extracorporeal membrane oxygenation after in-hospital cardiac arrest between January 2004 and December 2013. Patients treated between 0800 on Monday to 1759 on Friday were considered to receive weekday care and patients treated between 1800 on Friday through 0759 on Monday were considered to receive weekend care.
  
  
  RESULTS
  A total of 135 cases of ECPR for in-hospital cardiac arrest occurred during the weekday (64 during daytime hours and 71 during nighttime hours), and 65 cases occurred during the weekend (39 during daytime/evening hours and 26 during nighttime hours). Rates of survival to discharge were higher with weekday care than with weekend care (35.8% versus 21.5%, p = 0.041). Cannulation failure was more frequent in the weekend group (1.5% versus 7.7%, p = 0.038). Complication rates were higher on the weekend than on the weekday, including cannulation site bleeding (3.0% versus 10.8%, p = 0.041), limb ischemia (5.9% versus 15.6%, p = 0.026), and procedure-related infections (0.7% versus 9.2%, p = 0.005).
  
  
  CONCLUSIONS
  ECPR on the weekend was associated with a lower survival rate and lower resuscitation quality, including higher cannulation failure and higher complication rate.
authors.affiliation: Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dae-Sang
authors.initials: DS
authors.lastname: Lee
authors.affiliation: Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Chi Ryang
authors.initials: CR
authors.lastname: Chung
authors.affiliation: Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.affiliation: Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Chi-Min
authors.initials: CM
authors.lastname: Park
authors.affiliation: Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.affiliation: Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: jhysmc@gmail.com.
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Yang
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D003657:Decision Making; D005112:Extracorporeal Circulation / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors