{"id":30838,"date":"2026-07-22T04:32:00","date_gmt":"2026-07-21T20:32:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30838"},"modified":"2026-07-22T05:43:58","modified_gmt":"2026-07-21T21:43:58","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%a4%9c%e9%97%b4%e9%99%a2%e5%a4%96%e5%bf%83%e8%b7%b3%e9%aa%a4%e5%81%9c%e7%9a%84%e7%94%9f%e5%ad%98%e7%8e%87","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30838","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u591c\u95f4\u9662\u5916\u5fc3\u8df3\u9aa4\u505c\u7684\u751f\u5b58\u7387"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Emergency Medicine<\/p>\n\n\n\n

Out-of-Hospital Cardiac Arrest Survival at Nighttime: A Nationwide Cohort Study<\/h1>\n\n\n\n

Joshua M. Kimbrell, Tanner Smida, Judah A. Kreinbrook, et al<\/h3>\n\n\n\n

JAMA Netw Open 2026;9;(4):e269828.<\/h3>\n\n\n\n

doi:10.1001\/jamanetworkopen.2026.9828<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Does out-of-hospital cardiac arrest resuscitation with nighttime prehospital response remain associated with low rates of survival using contemporary data?<\/p>\n\n\n\n

Findings<\/strong>  In this retrospective cohort study including 874\u202f415 patients from a nationwide out-of-hospital cardiac registry from 2013 to 2024, patients with prehospital response at nighttime (11:00 pm to 6:59 am) had 15% lower adjusted odds of neurologically favorable survival and 14% lower adjusted odds of return of spontaneous circulation.<\/p>\n\n\n\n

Meaning<\/strong>  These findings suggest that nighttime prehospital responses to patients with out-of-hospital cardiac arrest are associated with lower odds of survival than daytime responses, and further work should explore effective strategies to improve survival at night.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Studies have demonstrated lower odds of survival from out-of-hospital cardiac arrest (OHCA) during nighttime hours, but this has not been studied in North America since 2013, and it is unclear what factors might explain this survival difference.<\/p>\n\n\n\n

Objective<\/strong>  To identify whether OHCA survival during nighttime hours remains lower than during daytime hours using contemporary data and whether it can be explained by variable patient physiology or emergency care factors.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This cohort study included adults (aged \u226518 years) with OHCA in the Cardiac Arrest Registry for Enhanced Survival from 2013 to 2024.<\/p>\n\n\n\n

Exposure<\/strong>  Daytime was defined as 7:00 am to 10:59 pm, and nighttime was defined as 11:00 pm to 6:59 am.<\/p>\n\n\n\n

Main Outcome and Measures<\/strong>  Primary outcomes were sustained return of spontaneous circulation (ROSC) and neurologically favorable survival (Cerebral Performance Category score of 2 or more). A multilevel mixed-effects logistic regression model with prehospital agency as a random effect and patient or treatment characteristics as fixed effects was used. A similar analysis of postresuscitation survival was performed among patients with sustained ROSC, adjusting for the time-to-cardiopulmonary resuscitation interval and defibrillation status. A mediation analysis was performed to identify whether the prehospital response interval mediates the association.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Of 1\u202f151\u202f845 patients in the registry, 874\u202f415 were eligible and included in the analysis, and the median (IQR) age in the cohort was 64 (52-75) years with 557\u202f515 males (63.8%) and 181 878 Black or African American patients (20.8%), 146 352 Hispanic or Latino patients (16.7%), and 447\u202f646 White patients (51.2%). A minority of OHCA responses occurred at nighttime (241\u202f967 [27.7%]), and the odds of sustained ROSC and neurologically favorable survival were lower at nighttime than daytime (sustained ROSC: 62\u202f548 [25.8%] vs 193\u202f486 [30.6%]; adjusted odds ratio [aOR], 0.85; 95% CI, 0.84-0.86; neurologically favorable survival: 16\u202f234 [6.7%] vs 58\u202f542 [9.3%]; aOR, 0.84; 95% CI, 0.82-0.86). Among those with sustained ROSC, the odds of postresuscitation survival at nighttime were also lower than daytime (aOR, 0.93; 95% CI, 0.90-0.95). The prehospital response interval partially mediated the nighttime survival disadvantage, with approximately 12.6% of the total effect mediated by the response interval.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this cohort study of OHCA, nighttime response was associated with lower adjusted odds of sustained ROSC, neurologically favorable survival, and postresuscitation survival. Emergency care factors accounted for only a portion of the decreased odds of survival at nighttime.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Emergency Medicine Out-of- […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30838"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30838"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30838\/revisions"}],"predecessor-version":[{"id":31285,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30838\/revisions\/31285"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30838"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30838"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30838"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}