Abstract
Aims
To evaluate and compare survival after out-of-hospital (OHCA), where an automated
external defibrillator (AED) was used, in densely, moderately and thinly populated
areas. Also, to evaluate the association between AED retrieval distance and survival
after OHCA.
Methods
From 2014 to 2018, AEDs used during OHCA in the region of Southern Denmark were systematically
collected. OHCAs were included if the OHCA address was known. OHCAs at nursing homes
were excluded. To evaluate population density, a map with 1000 × 1000 meter grid cells
was used with each cell color-graded according to the number of inhabitants. Densely,
moderately and thinly populated areas were defined as ≥200 inhabitants, 20–199 inhabitants
and 0–19 inhabitants per km2, respectively. Primary outcome was 30-day survival.
Results
A total of 423 cases of OHCA were included, of which 207 (49%) occurred in densely
populated areas, while 78 (18%) and 138 (33%) occurred in moderately and thinly populated
areas, respectively. AED retrieval distances were: densely populated 105 m (IQR 5–450),
moderately populated 220 m (IQR 5–450) and thinly populated 350 m (IQR 5–1500) (P < 0.001).
Thirty-day survival was 40%, 31% and 34%, respectively (P = 0.3). In a multivariable
regression analysis, mortality increased with 10% per 100 m an AED was placed further
away from the site of OHCA.
Conclusion
Survival after OHCA, where an AED was used, did not seem to differ in thinly, moderately
and densely populated areas. The length of the AED retrieval distance, however, was
correlated with reduced survival after adjusting for other potentially explanatory
variables.
Keywords
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Article info
Publication history
Published online: November 09, 2021
Accepted:
November 1,
2021
Received in revised form:
November 1,
2021
Received:
September 17,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
