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.

Abstract

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.

• Authors: Takefumi Kishimori, Takeyuki Kiguchi, Kosuke Kiyohara, Tasuku Matsuyama, Haruka Shida, Chika Nishiyama, Daisuke Kobayashi, Satoe Okabayashi, Tomonari Shimamoto, Sumito Hayashida, Tetsuhisa Kitamura, Takashi Kawamura, Taku Iwami
• Journal: International journal of cardiology (Int J Cardiol) Vol. 299 Pg. 140-146 (01 15 2020) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 31400888 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Elsevier B.V. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Cardiopulmonary Resuscitation (instrumentation, methods)
• Defibrillators
• Emergency Medical Services (methods)
• Female
• Humans
• Male
• Middle Aged
• Nervous System Diseases (diagnosis, epidemiology)
• Out-of-Hospital Cardiac Arrest (epidemiology, therapy)
• Population Surveillance (methods)
• Propensity Score
• Prospective Studies
• Public Policy
• Registries
• Treatment Outcome
• Young Adult