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June 11, 2008

Survival Patterns With In-Hospital Cardiac Arrest

JAMA. 2008;299(22):2625-2627. doi:10.1001/jama.299.22.2625-b

To the Editor: Dr Peberdy and colleagues,1 along with other investigators from the National Registry of Cardiopulmonary Resuscitation (NRCPR), demonstrated lower survival for resuscitation attempts that occurred during nights and on weekends after statistically controlling for a large number of variables previously associated with survival. Because other in-hospital resuscitation registries have data from only 1 institution, only NRCPR is in a position to examine interinstitution variability for the phenomenon the authors identified. They included hospital size as a covariate in their logistic regression analyses but have sufficient data to consider interinstitution variability, at least among the larger institutions. An assessment of the extent to which institutions differ in their experience of the night/weekend effect would add considerably to the ability to interpret results from single-institution registries; cross-institution variations in outcome have long exhibited a broad range and are currently unexplained.2

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