SEASONAL variations can be observed in the incidence of in-hospital cardiac arrest for both males and females across the USA, according to Arshad Jahangir, Aurora St. Luke’s Medical Centers, Milwaukee, Wisconsin, USA, and colleagues. The researchers noted that a consistent winter peak requires further investigation.
Using National Inpatient Sample (NIS) data from 2005–2019, the researchers investigated the incidence of in-hospital cardiac arrest across four seasons. They analysed overall seasonal trends in the incidence of in-hospital cardiac arrest, and trends stratified by sex, age, and region. Additionally, they incorporated common causes of admission that led to in-hospital cardiac arrest; differences among patients with shockable versus non-shockable arrest; independent predictors; and seasonal variation in in-hospital cardiac arrest-related in-hospital mortality and length of stay.
A consistent winter peak in the incidence of in-hospital cardiac arrest was observed among males and females throughout the study period across all age groups, except young adults (<45 or younger), and across all regions.
The adjusted risk for in-hospital cardiac arrest was higher during winter compared to summer in 2019 (P=0.033). Patients with shockable in-hospital cardiac arrest were mostly admitted with cardiac conditions, while those with non-shockable in-hospital cardiac arrest were mostly admitted with non-cardiac conditions. Interestingly, no seasonal variations were observed for in-hospital mortality after an in-hospital cardiac arrest.
Jahangir and colleagues emphasised that more resources may be required in winter compared to summer, in order to counter factors that can cause a cardiopulmonary collapse in the hospital. Accordingly, the identification of vulnerable patients who require closer monitoring, as well as primary and secondary prevention of myocardial infarction, atrial fibrillation, and heart failure progression, were some of the strategies suggested by the authors to reduce the incidence of vulnerable patients. They added that the high-risk population identified in their study may assist healthcare providers and hospitals to appropriately triage and monitor these patients.
