Abstract
Aim
To compare walking access times to automated external defibrillators (AEDs) between
area-level quintiles of socioeconomic status (SES) in out-of-hospital cardiac arrest
(OHCA) cases occurring in 2 major urban regions of Canada and France.
Methods
This was an international, multicenter, retrospective cohort study of adult, non-traumatic
OHCA cases in the metropolitan Vancouver (Canada) and Rhône County (France) regions
that occurred between 2014 and 2018. We calculated area-level SES for each case, using
quintiles of country-specific scores (Q5 = most deprived). We identified AED locations
from local registries. The primary outcome was the simulated walking time from the
OHCA location to the closest AED (continuous and dichotomized by a 3-minute 1-way
threshold). We fit multivariate models to analyze the association between OHCA-to-AED
walking time and outcomes (Q5 vs others).
Results
A total of 6,187 and 3,239 cases were included from the Metro Vancouver and Rhône
County areas, respectively. In Metro Vancouver Q5 areas (vs Q1-Q4), areas, AEDs were
farther from (79 % over 400 m from case vs 67 %, p < 0.001) and required longer walking
times to (97 % above 3 min vs 91 %, p < 0.001) cases. In Rhône Q5 areas, AEDs were
closer than in other areas (43 % over 400 m from case vs 50 %, p = 0.01), yet similarly
poorly accessible (85 % above 3 min vs 86 %, p = 0.79). In multivariate models, AED
access time ≥ 3 min was associated with decreased odds of survival at hospital discharge
in Metro Vancouver (odds ratio 0.41, 95 % CI [0.23–0.74], p = 0.003).
Conclusions
Accessibility of public AEDs was globally poor in Metro Vancouver and Rhône, and even
poorer in Metro Vancouver’s socioeconomically deprived areas.
Keywords
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Article info
Publication history
Published online: October 26, 2022
Accepted:
October 18,
2022
Received in revised form:
October 18,
2022
Received:
July 29,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
