Public-access automated external defibrillator pad application and favorable neurological outcome after out-of-hospital cardiac arrest in public locations: A prospective population-based propensity score-matched study.
Adolescent
Adult
Aged
Cardiopulmonary Resuscitation
/ instrumentation
Defibrillators
Emergency Medical Services
/ methods
Female
Humans
Male
Middle Aged
Nervous System Diseases
/ diagnosis
Out-of-Hospital Cardiac Arrest
/ epidemiology
Population Surveillance
/ methods
Propensity Score
Prospective Studies
Public Policy
Registries
Treatment Outcome
Young Adult
Automated external defibrillator
Cardiac arrest
Cardiopulmonary resuscitation
Public policy
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 01 2020
15 01 2020
Historique:
received:
12
04
2019
revised:
08
07
2019
accepted:
17
07
2019
pubmed:
12
8
2019
medline:
24
11
2020
entrez:
12
8
2019
Statut:
ppublish
Résumé
Randomized controlled trials or observational studies showed that the use of public-access automated external defibrillator (AED) was effective for patients with out-of-hospital cardiac arrest (OHCA). However, it is unclear whether public-access AED use is effective for all patients with OHCA irrespective of first documented rhythm. We aimed to evaluate the effect of public-access AED use for OHCA patients considering first documented rhythm (shockable or non-shockable) in public locations. From the Utstein-style registry in Osaka City, Japan, we obtained information on adult patients with OHCA of medical origin in public locations before emergency-medical-service personnel arrival between 2011 and 2015. Primary outcome was 1-month survival with favorable neurological outcome. Multivariable logistic regression analysis was performed to assess the association between the public-access AED pad application and favorable neurological outcome after OHCA by using one-to-one propensity score matching analysis. Among 1743 eligible patients, a total of 336 (19.3%) patients received public-access AED pad application. The proportion of patients who survived 1-month with favorable neurological outcome was significantly higher in the pad application group than in the non-pad application group (29.8% vs. 9.7%; adjusted odds ratio [AOR], 2.85; 95% confidence interval [CI], 1.73-4.68, AOR after propensity score matching, 2.46; 95% CI, 1.29-4.68). In a subgroup analysis, the AORs of patients with shockable or non-shockable rhythms were 3.36 (95% CI, 1.78-6.35) and 2.38 (95% CI, 0.89-6.34), respectively. Public-access AED pad application was associated with better outcome among patients with OHCA of medical origin in public locations irrespective of first documented rhythm.
Sections du résumé
BACKGROUND
Randomized controlled trials or observational studies showed that the use of public-access automated external defibrillator (AED) was effective for patients with out-of-hospital cardiac arrest (OHCA). However, it is unclear whether public-access AED use is effective for all patients with OHCA irrespective of first documented rhythm. We aimed to evaluate the effect of public-access AED use for OHCA patients considering first documented rhythm (shockable or non-shockable) in public locations.
METHODS
From the Utstein-style registry in Osaka City, Japan, we obtained information on adult patients with OHCA of medical origin in public locations before emergency-medical-service personnel arrival between 2011 and 2015. Primary outcome was 1-month survival with favorable neurological outcome. Multivariable logistic regression analysis was performed to assess the association between the public-access AED pad application and favorable neurological outcome after OHCA by using one-to-one propensity score matching analysis.
RESULTS
Among 1743 eligible patients, a total of 336 (19.3%) patients received public-access AED pad application. The proportion of patients who survived 1-month with favorable neurological outcome was significantly higher in the pad application group than in the non-pad application group (29.8% vs. 9.7%; adjusted odds ratio [AOR], 2.85; 95% confidence interval [CI], 1.73-4.68, AOR after propensity score matching, 2.46; 95% CI, 1.29-4.68). In a subgroup analysis, the AORs of patients with shockable or non-shockable rhythms were 3.36 (95% CI, 1.78-6.35) and 2.38 (95% CI, 0.89-6.34), respectively.
CONCLUSIONS
Public-access AED pad application was associated with better outcome among patients with OHCA of medical origin in public locations irrespective of first documented rhythm.
Identifiants
pubmed: 31400888
pii: S0167-5273(19)31851-0
doi: 10.1016/j.ijcard.2019.07.061
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
140-146Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.