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

Department of Clinical Medicine

25 Citations (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.

Original language	English
Journal	Resuscitation
Volume	136
Pages (from-to)	30-37
ISSN	0300-9572
DOIs	https://doi.org/10.1016/j.resuscitation.2019.01.014
Publication status	Published - Mar 2019

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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, vol. 136, pp. 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

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