Abstract
Background
Automated external defibrillators (AEDs) can be used by bystanders to provide rapid
defibrillation for patients with out-of-hospital cardiac arrest (OHCA). Whether neighborhood
characteristics are associated with AED use is unknown. Furthermore, the association
between AED use and outcomes has not been well characterized for all (i.e. shockable and non-shockable) public OHCAs.
Methods
We included public, non-911-responder witnessed OHCAs registered in the Cardiac Arrest
Registry to Enhance Survival (CARES) between 2013 and 2016. The primary patient outcome
was survival to hospital discharge with a favorable functional outcome. We first assessed
the association between neighborhood characteristics and bystander AED use using logistic
regression and then assessed the association between bystander AED use and patient
outcomes in a propensity score matched cohort.
Results
25,182 OHCAs were included. Several neighborhood characteristics, including the proportion
of people living alone, the proportion of white people, and the proportion with a
high-school degree or higher, were associated with bystander AED use. 5132 OHCAs were
included in the propensity score-matched cohort. Bystander AED use was associated
with an increased risk of a favorable functional outcome (35% vs. 25%, risk difference: 9.7% [95% confidence interval: 7.2%, 12.2%], risk ratio: 1.38
[95% confidence interval: 1.27, 1.50]). This was driven by increased favorable functional
outcomes with AED use in patients with shockable rhythms (58% vs. 39%) but not in patients with non-shockable rhythms (10% vs. 10%).
Conclusions
Specific neighborhood characteristics were associated with bystander AED use in OHCA.
Bystander AED use was associated with an increase in favorable functional outcome.
Keywords
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Article info
Publication history
Published online: February 22, 2018
Accepted:
February 19,
2018
Received in revised form:
February 12,
2018
Received:
December 7,
2017
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at https://doi.org/10.1016/j.resuscitation.2018.02.021.
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
