Does the risk of out-of-hospital cardiac arrest (OHCA) incidence change by day of week and holidays? A nationwide case time series study in South Korea

Objectives Several studies suggested that short-term variations in out-of-hospital cardiac arrest (OHCA) might be associated with the day of the week and holidays. However, most existing findings were based on Western countries, outdated data (the 1990s or 2000s) and analytical methods that could not control potential confounders.Design Case time-series design.Setting The national OHCA surveillance (a population-level surveillance system operated by the Korea Disease Control and Prevention Agency) from 2015 to 2019.Participants A total of 89 164 cardiac-origin OHCA cases.Interventions Not applicable.Primary and secondary outcome measures Cardiac-origin OHCA incidents (primary) and fatality of the OHCA incidents (secondary).Results We found that Mondays (relative risk (RR): 1.019 with 95% CI: 1.009 to 1.029) and Sunday (RR: 1.015 with 95% CI: 1.005 to 1.025) had the highest risk of OHCA incidence compared with other weekdays. Holidays showed a higher association with increased OHCA risks than non-holidays. Higher RRs were observed on Christmas (RR: 1.096 with 95% CI: 1.063 to 1.129) and Lunar New Year’s Day (RR: 1.082 with 95% CI: 1.060 to 1.104) compared with non-holidays. These patterns by the day of the week and holidays were heterogeneous by age, sex and urbanicity level.Conclusions This study provides epidemiological evidence of the association of the day of the week and holidays with OHCA incidents in South Korea, using national surveillance data and state-of-the-science statistical methods. Our findings could contribute to the implications for more targeted action plans and public health resource mobilisation against OHCA.