ABSTRACTS
The Midnight Gap: Out-of-Hospital Cardiac Arrest Survival in Poland Drops at NightAuthor: Anna Zadlo | MSc | Department of Medical Education, Centre of Innovative Medical Education, Jagiellonian University Med Associate Authors:
Background Out-of-hospital cardiac arrest (OHCA) has low survival rates, with worse outcomes at night due to delayed EMS response, resource limitations, and workforce fatigue. Timely resuscitation is crucial, but logistical challenges exacerbate disparities. Since randomized trials are unfeasible, all-comers registries provide essential data to bridge evidence gaps and improve EMS protocols. Aims This study aimed to investigate the impact of day versus night shifts on OHCA outcomes, focusing on ROSC rates, 30-day survival, and timing metrics within EMS operations. Methods This study analyzed OHCA cases in Poland from September to November 2022 using EMS records and national death registry data. Patients were grouped by time of arrest (on-hours: 7:00 AM–6:59 PM; off-hours: 7:00 PM–6:59 AM) and matched 1:1 using propensity scores (1,194 pairs). Statistical analyses included Mann–Whitney U and Chi-square tests (p≤0.05). Results Our findings reveal significant disparities in OHCA outcomes between day and night shifts. ROSC rates were notably lower at night (20.9% vs. 34.8%, p < 0.001), as was 30-day survival (47.0% vs. 59.3%, p = 0.001). EMS response times were significantly longer during nighttime hours (12:23 vs. 11:14 min, p = 0.011). Conclusions The disparities in OHCA outcomes between day and night may result from workforce fatigue, limited hospital resources, and lower bystander CPR rates. Addressing these issues requires changes like optimizing EMS shifts, improving dispatcher-assisted CPR, expanding defibrillation programs, and boosting hospital preparedness at night to improve survival rates and patient outcomes.
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