Determining Risk for Out-of-Hospital Cardiac Arrest by Location Type in a Canadian Urban Setting to Guide Future Public Access Defibrillator Placement - 24/04/13
, Jonathan H. Hsu, BHSc b, Sabrina K. Tang, BASc c, Roshan Jeyakumar, BSc b, Timothy C.Y. Chan, PhD c
Address for correspondence: Steven C. Brooks, MD, MScRésumé |
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 [CI] 0 to 1.63), jail (0.62; 95% CI 0.3 to 1.06), hotel/motel (0.15; 95% CI 0.12 to 0.18), hostel/shelter (0.14; 95% CI 0.067 to 0.19), and convention center (0.11; 95% CI 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.
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| Supervising editor: Kathy J. Rinnert, MD, MPH |
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| Author contributions: SCB conceived of the study, was responsible for statistical analysis and study design, supervised the study, and takes responsibility for the content of the article. All authors contributed to acquisition, analysis, and interpretation of data and drafting and critical revision of the article. JHH provided administrative and technical support. SCB takes responsibility for the paper as a whole. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. Dr. Brooks was supported through a Jumpstart Resuscitation Research Scholarship from the Heart and Stroke Foundation of Canada for his work on this article. The Resuscitation Outcome Consortium is supported by a series of cooperative agreements to 10 regional clinical centers and 1 data coordinating center (5U01 HL077863, HL077881, HL077871, HL077872, HL077866, HL077908, HL077867, HL077885, HL077885, HL077863) from the National Heart, Lung, and Blood Institute, in partnership with the National Institute of Neurological Disorders and Stroke, the Canadian Institutes of Health Research (CIHR)–Institute of Circulatory and Respiratory Health, Defence Research and Development Canada, the National American Heart Association, and the Heart and Stroke Foundation of Canada. |
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| Publication date: Available online March 20, 2013. |
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| Please see page 531 for the Editor's Capsule Summary of this article. |
Vol 61 - N° 5
P. 530 - mai 2013 Retour au numéro
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