Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study

Lena Karlsson; Carolina Malta Hansen; Mads Wissenberg; Steen Møller Hansen; Freddy K Lippert; Shahzleen Rajan; Kristian Kragholm; Sidsel G Møller; Kathrine Bach Søndergaard; Gunnar H Gislason; Christian Torp-Pedersen; Fredrik Folke

doi:10.1016/j.resuscitation.2019.01.014

Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study

Lena Karlsson, Carolina Malta Hansen, Mads Wissenberg, Steen Møller Hansen, Freddy K Lippert, Shahzleen Rajan, Kristian Kragholm, Sidsel G Møller, Kathrine Bach Søndergaard, Gunnar H Gislason, Christian Torp-Pedersen, Fredrik Folke

Institut for Klinisk Medicin

25 Citationer (Scopus)

18 Downloads (Pure)

Abstract

AIMS: Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations.

METHODS: In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located ≤200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival.

RESULTS: Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, <50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible: 13.8% vs. inaccessible: 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible: 28.8% vs. inaccessible: 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss >50%, due to limited AED accessibility.

CONCLUSIONS: The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.

Originalsprog	Engelsk
Tidsskrift	Resuscitation
Vol/bind	136
Sider (fra-til)	30-37
ISSN	0300-9572
DOI	https://doi.org/10.1016/j.resuscitation.2019.01.014
Status	Udgivet - mar. 2019

Adgang til dokumentet

10.1016/j.resuscitation.2019.01.014Licens: CC BY-NC-ND

1-s2.0-S0300957218309870-mainForlagets udgivne version, 1,02 MBLicens: CC BY-NC-ND

Citationsformater

Karlsson, L., Malta Hansen, C., Wissenberg, M., Møller Hansen, S., Lippert, F. K., Rajan, S., Kragholm, K., Møller, S. G., Bach Søndergaard, K., Gislason, G. H., Torp-Pedersen, C., & Folke, F. (2019). Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study. Resuscitation, 136, 30-37. https://doi.org/10.1016/j.resuscitation.2019.01.014

Karlsson, L, Malta Hansen, C, Wissenberg, M, Møller Hansen, S, Lippert, FK, Rajan, S, Kragholm, K, Møller, SG, Bach Søndergaard, K, Gislason, GH, Torp-Pedersen, C & Folke, F 2019, 'Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study', Resuscitation, bind 136, s. 30-37. https://doi.org/10.1016/j.resuscitation.2019.01.014

@article{06600c7f18564868aa27761b2cd27a4c,

title = "Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study",

abstract = "AIMS: Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations.METHODS: In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located ≤200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival.RESULTS: Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, <50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible: 13.8% vs. inaccessible: 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible: 28.8% vs. inaccessible: 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss >50%, due to limited AED accessibility.CONCLUSIONS: The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.",

author = "Lena Karlsson and {Malta Hansen}, Carolina and Mads Wissenberg and {M{\o}ller Hansen}, Steen and Lippert, {Freddy K} and Shahzleen Rajan and Kristian Kragholm and M{\o}ller, {Sidsel G} and {Bach S{\o}ndergaard}, Kathrine and Gislason, {Gunnar H} and Christian Torp-Pedersen and Fredrik Folke",

year = "2019",

month = mar,

doi = "10.1016/j.resuscitation.2019.01.014",

language = "English",

volume = "136",

pages = "30--37",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Automated external defibrillator accessibility is crucial for bystander defibrillation and survival

T2 - A registry-based study

AU - Karlsson, Lena

AU - Malta Hansen, Carolina

AU - Wissenberg, Mads

AU - Møller Hansen, Steen

AU - Lippert, Freddy K

AU - Rajan, Shahzleen

AU - Kragholm, Kristian

AU - Møller, Sidsel G

AU - Bach Søndergaard, Kathrine

AU - Gislason, Gunnar H

AU - Torp-Pedersen, Christian

AU - Folke, Fredrik

PY - 2019/3

Y1 - 2019/3

N2 - AIMS: Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations.METHODS: In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located ≤200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival.RESULTS: Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, <50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible: 13.8% vs. inaccessible: 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible: 28.8% vs. inaccessible: 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss >50%, due to limited AED accessibility.CONCLUSIONS: The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.

AB - AIMS: Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations.METHODS: In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located ≤200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival.RESULTS: Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, <50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible: 13.8% vs. inaccessible: 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible: 28.8% vs. inaccessible: 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss >50%, due to limited AED accessibility.CONCLUSIONS: The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.

U2 - 10.1016/j.resuscitation.2019.01.014

DO - 10.1016/j.resuscitation.2019.01.014

M3 - Journal article

C2 - 30682401

SN - 0300-9572

VL - 136

SP - 30

EP - 37

JO - Resuscitation

JF - Resuscitation

ER -

Automated external defibrillator accessibility is crucial for bystander defibrillation and survival: A registry-based study

Abstract

Adgang til dokumentet

Fingeraftryk

Citationsformater