Relationship between socioeconomic factors, distribution of public access defibrillators and incidence of out-of-hospital cardiac arrest

RESUSCITATION

卷:138

Article

Dicker, Bridget^1,2  Garrett, Nick³  Wong, Samuel²  McKenzie, Helen¹⁰  McCarthy, John⁵  Jenkin, Gareth⁶  Smith, Tony²  Skinner, Jonathan R.⁴  Pegg, Tammy¹¹  Devlin, Gerry^7,8  Swain, Andrew¹  Scott, Tony⁹  Todd, Verity^1,2 

[1] Auckland Univ Technol, Paramed Dept, Auckland, New Zealand

[2] St John New Zealand, Clin Audit & Res, Auckland, New Zealand

[3] Auckland Univ Technol, Biostat & Epidemiol Dept, Auckland, New Zealand

[4] Starship Childrens Hosp, Paediat & Congenital Cardiac Serv, Auckland, New Zealand

[5] Minist Hlth, Wellington, New Zealand

[6] AED Locat, Auckland, New Zealand

[7] Gisbourne Hosp, Tairawhiti Dist Hlth, Gisbourne, New Zealand

[8] Heart Fdn NZ, Auckland, New Zealand

[9] Waitemata Dist Hlth Board, Cardiol, Auckland, New Zealand

[10] Northern Reg Alliance, Auckland, New Zealand

[11] Nelson Marlborough Dist Hlth Board, Cardiol, Nelson, New Zealand

关键词: Automated external defibrillator (AED);    Public access defibrillator (PAD);    Out-of-hospital cardiac arrest (OHCA);    Deprivation;    Ethnicity;    Resuscitation;    Bystander;    Defibrillation;    Cardiopulmonary resuscitation;   

DOI  :  10.1016/j.resuscitation.2019.02.022

来源: Elsevier

【 摘 要 】

Background: Survival from out-of-hospital cardiac arrest (OHCA) is improved when public access defibrillators are used. Areas of socioeconomic deprivation may have higher rates of OHCA and thus a greater demand for public access defibrillators. We aimed to determine if there was a relationship between socioeconomic factors, the geographic distribution of public access defibrillators (PADs) and incidence of OHCA. Method: Socioeconomic deprivation data was obtained from the Census-based 2013 Index of Deprivation. Spatial information for PADs was obtained from a New Zealand PAD database (AED Locations) in 2016 and 2018. Location data for OHCA was obtained from the St John New Zealand OHCA registry for the period 1 October 2013 to 30 June 2016. Relationships between these variables were analysed using a Poisson regression analysis. Results: Cardiac arrest incidence increased with increasing deprivation. The incidence in the most deprived areas of 156.5 events per 100,000 person years (135.4-180.9, 95% CI) is double the incidence in the least deprived areas at 78.0 events per 100,000 person years (66.4-91.7, 95% CI). Significant increases in the rates of OHCA were observed with every 1% increase in proportions of Maori (1.0%, 0.61-1.4%, 95% CI, p = 0.001), Pacific Peoples (0.6%, 0.21-0.9%, p = 0.005), >65 year olds (3.7%, 3.0-4.3%, p < 0.001), and males (3.7 %, 1.8-5.6%, p > 0.001). In 2018, the decile 10 areas had the lowest coverage of PADs (65% of these areas contained a PAD) compared with less deprived areas (68-84%, median 81%). Conclusions: The most socioeconomically deprived communities had the highest incidence of OHCA and the least availability of PADs. This provides impetus for targeted PAD placement in areas of higher deprivation.

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