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Public access defibrillators: Gender-based inequities in access and application

  • Brian Grunau
    Correspondence
    Corresponding author at: Department of Emergency Medicine, St. Paul’s Hospital, 1081 Burrard St., Vancouver British Columbia, V6Z 1Y6, Canada.
    Affiliations
    Department of Emergency Medicine, University of British Columbia, British Columbia, Canada

    St. Paul’s Hospital, Vancouver, British Columbia, Canada

    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    British Columbia Emergency Health Services, British Columbia, Canada

    The British Columbia Emergency Medicine Network, British Columbia, Canada
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  • Karin Humphries
    Affiliations
    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
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  • Robert Stenstrom
    Affiliations
    Department of Emergency Medicine, University of British Columbia, British Columbia, Canada

    St. Paul’s Hospital, Vancouver, British Columbia, Canada

    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    The British Columbia Emergency Medicine Network, British Columbia, Canada
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  • Sarah Pennington
    Affiliations
    Providence Health Care Research Institute, Vancouver, Canada
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  • Frank Scheuermeyer
    Affiliations
    Department of Emergency Medicine, University of British Columbia, British Columbia, Canada

    St. Paul’s Hospital, Vancouver, British Columbia, Canada

    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    The British Columbia Emergency Medicine Network, British Columbia, Canada
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  • Sean van Diepen
    Affiliations
    Department of Critical Care and Division of Cardiology, Department of Medicine, University of Alberta, Canada
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  • Emad Awad
    Affiliations
    The Faculty of Medicine, University of British Columbia, British Columbia, Canada
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  • Rahaf Al Assil
    Affiliations
    Providence Health Care Research Institute, Vancouver, Canada
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  • Takahisa Kawano
    Affiliations
    The Department of Emergency Medicine, University of Fukui Hospital, Fukui Prefecture, Japan
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  • Steven Brooks
    Affiliations
    Queen’s University, Kingston, Ontario, Canada
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  • Bobby Gu
    Affiliations
    The Faculty of Medicine, University of British Columbia, British Columbia, Canada
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  • Jim Christenson
    Affiliations
    Department of Emergency Medicine, University of British Columbia, British Columbia, Canada

    St. Paul’s Hospital, Vancouver, British Columbia, Canada

    Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada

    The British Columbia Emergency Medicine Network, British Columbia, Canada
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      Abstract

      Aim

      While public access automated external defibrillator (AED) programs appear to improve outcomes in out-of-hospital cardiac arrest (OHCA) it is unclear if men and women benefit equally. We examined gender-based differences in OHCA location to determine what proportion were potentially eligible for public access AED application, and if patient gender was associated with AED utilization.

      Methods

      We analyzed data from the Resuscitation Outcomes Consortium registry (2011–2015). We compared differences in OHCA locations by gender. We fit multivariate logistic regression models, restricted to public location OHCAs and public-location cases with bystander intervention, to calculate the association between gender and public access AED application.

      Results

      Among 61 473 cases, 34% were female and 50% had bystander resuscitation. The incidence of public OHCA was 8.8% for women and 18% for men (risk difference 9.2%, 95% CI 8.7–9.7%). Women had significantly fewer OHCAs on roadways, in public buildings, places of recreation, and farms, but more in homes, non-acute healthcare facilities, and residential institutions. Female gender was associated with a lower odds of AED application in public OHCA (adjusted OR 0.76, 95% CI 0.64–0.90) and public-location cases with bystander interventions (adjusted OR 0.83, 95% CI 0.71–0.99).

      Conclusion

      Women had fewer OHCA in public locations that may have public access AEDs. Even among public location OHCA with bystander interventions, women were less likely to have public access AED applied. Initiatives to optimize AED locations and to engage the public with gender-specific resuscitation training may improve outcomes in women with OHCA.

      Keywords

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