Determining Risk for Out-of-Hospital Cardiac Arrest by Location Type in a Canadian Urban Setting to Guide Future Public Access Defibrillator Placement

作者：Brooks Steven C^*; Hsu Jonathan H; Tang Sabrina K; Jeyakumar Roshan; Chan Timothy C Y

来源：Annals of Emergency Medicine, 2013, 61(5): 530-538.

DOI：10.1016/j.annemergmed.2012.10.037

Study objective: Automated external defibrillator use by lay bystanders during out-of-hospital cardiac arrest rarely occurs but can improve survival. We seek to estimate risk for out-of-hospital cardiac arrest by location type and evaluate current automated external defibrillator deployment in a Canadian urban setting to guide future automated external defibrillator deployment.
Methods: This was a retrospective analysis of a population-based out-of-hospital cardiac arrest database. We included consecutive public location, nontraumatic, out-of-hospital cardiac arrests occurring in Toronto from January 1, 2006, to June 30, 2010, captured in the Resuscitation Outcomes Consortium Epistry database. Two investigators independently categorized each out-of-hospital cardiac arrest and automated external defibrillator location into one of 38 categories. Total site counts in each location category were used to estimate average annual per-site cardiac arrest incidence and determine the relative automated external defibrillator coverage for each location type.
Results: There were 608 eligible out-of-hospital cardiac arrest cases. The top 5 location categories by average annual out-of-hospital cardiac arrests per site were race track/casino (0.67; 95% confidence interval [Cl] 0 to 1.63), jail (0.62; 95% Cl 0.3 to 1.06), hotel/motel (0.15; 95% Cl 0.12 to 0.18), hostel/shelter (0.14; 95% Cl 0.067 to 0.19), and convention center (0.11; 95% Cl 0 to 0.43). Although schools were relatively lower risk for cardiac arrest, they represented 72.5% of automated external defibrillator covered locations in the study region. Some higher-risk location types such as hotel/motel, hostel/shelter, and rail station were severely underrepresented with respect to automated external defibrillator coverage.
Conclusion: We have identified types of locations with higher per-site risk for cardiac arrest relative to others. We have also identified potential mismatches between cardiac arrest risk by location type and registered automated external defibrillator distribution in a Canadian urban setting.

• 出版日期2013-5