Clinical Report: Cardiac Arrest Patterns After Holidays

Overview

A nationwide South Korean study published in JAMA Network Open found a 9% increase in out-of-hospital cardiac arrest (OHCA) incidence on the first working day after holidays compared to baseline weekdays, based on data from 2013 to 2023. This increase was particularly notable among older adults and those with nonshockable rhythms.

Background

Understanding the patterns of out-of-hospital cardiac arrest is crucial for improving public health responses and emergency preparedness. The observed increase in cardiac arrests following holidays may reflect underlying behavioral and physiological changes, which could inform targeted interventions. This study highlights the need for awareness and readiness during specific temporal contexts, such as post-holiday periods.

Data Highlights

Key Findings

• 9% higher incidence of OHCA on the first working day after holidays compared to baseline weekdays.
• Median age of patients was 71 years, with approximately 64% being male.
• Higher incidence rates were observed in patients older than 65 years and those with cardiac causes of arrest.
• No significant increase in OHCA incidence after single-day holidays; longer holidays correlated with higher incidence.
• Behavioral changes post-holiday, such as increased alcohol consumption and stress, may contribute to the rise in cardiac arrests.
• Subgroup analyses showed consistent associations across sex, witness status, and residential area categories.

Clinical Implications

Healthcare providers should be aware of the increased risk of cardiac arrest following holidays, particularly in older adults and those with pre-existing cardiac conditions. Emergency services may need to enhance readiness and public awareness campaigns during these high-risk periods, including specific strategies for managing increased alcohol consumption and stress.

Conclusion

The findings underscore the importance of recognizing temporal patterns in cardiac arrest incidence, suggesting that targeted interventions could mitigate risks associated with post-holiday transitions. Further research is needed to explore the underlying factors contributing to these patterns.

References

1. JAMA Network Open, 2023 -- Incidence of Out-of-Hospital Cardiac Arrest on a Postholiday Weekday
2. European Journal of Preventive Cardiology, 2023 -- Fluid Retention, Decreased Physical Activity, and Variability in Heart Rate Observed During National Holidays in Patients with Cardiac Implantable Devices
3. Clinical Research in Cardiology, 2022 -- Clinical Features, Etiologies, and Outcome Predictors in Patients Experiencing In-Hospital Cardiac Arrest: Findings from the SURVIVE-ARREST Study
4. Critical Care, 2025 -- Unlocking survival in traumatic cardiac arrest: global insights, innovations, and unmet needs
5. JAMA Network Open — Is Poor Recognition of Out-of-Hospital Cardiac Arrest to Blame for Worse Rates of Survival at Night?
6. 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
7. Part 4: Systems of Care | American Heart Association CPR & First Aid
8. Incidence of Out-of-Hospital Cardiac Arrest on a Postholiday Weekday | Emergency Medicine | JAMA Network Open | JAMA Network