Eloi Marijon1, Wulfran Bougouin2, Muriel Tafflet2, Nicole Karam2, Daniel Jost2, Lionel Lamhaut2, Frankie Beganton2, Patricia Pelloux2, Hervé Degrange2, Guillaume Béal2, Jean-Pierre Tourtier2, Albert A Hagège2, Jean-Yves Le Heuzey2, Michel Desnos2, Florence Dumas2, Christian Spaulding2, David S Celermajer2, Alain Cariou2, Xavier Jouven2. 1. From Université Paris Descartes, France (E.M., W.B., M.T., N.K., L.L., F.B., G.B., A.H., J.-Y.L.H., M.D., F.D., C.S., A.C., X.J.); Paris Cardiovascular Research Center (PARCC-Inserm U970), France (E.M., W.B., M.T., N.K., L.L., F.B., G.B., F.D., C.S., A.C., X.J.); Hôpital Européen Georges Pompidou, Département de Cardiologie, Paris, France (E.M., N.K., A.H., J.-Y.L.H., M.D., C.S., X.J.); Département de Réanimation Médicale, Hôpital Cochin, Paris, France (W.B., A.C.); Service Médical d'Urgence-Brigade de Sapeurs-Pompiers de Paris, France (D.J., H.D., J.-P.T.); Service d'Aide Médicale Urgente de Paris (SAMU 75), France (L.L.); Atelier d'Urbanisme Parisien, Paris, France (P.P.); Département des Urgences, Hôpital Cochin, Paris, France (F.D.); and Sydney Medical School, Australia (D.S.C.). eloi_marijon@yahoo.fr. 2. From Université Paris Descartes, France (E.M., W.B., M.T., N.K., L.L., F.B., G.B., A.H., J.-Y.L.H., M.D., F.D., C.S., A.C., X.J.); Paris Cardiovascular Research Center (PARCC-Inserm U970), France (E.M., W.B., M.T., N.K., L.L., F.B., G.B., F.D., C.S., A.C., X.J.); Hôpital Européen Georges Pompidou, Département de Cardiologie, Paris, France (E.M., N.K., A.H., J.-Y.L.H., M.D., C.S., X.J.); Département de Réanimation Médicale, Hôpital Cochin, Paris, France (W.B., A.C.); Service Médical d'Urgence-Brigade de Sapeurs-Pompiers de Paris, France (D.J., H.D., J.-P.T.); Service d'Aide Médicale Urgente de Paris (SAMU 75), France (L.L.); Atelier d'Urbanisme Parisien, Paris, France (P.P.); Département des Urgences, Hôpital Cochin, Paris, France (F.D.); and Sydney Medical School, Australia (D.S.C.).
Abstract
BACKGROUND: Although the benefits of automatic external defibrillators are undeniable, their effectiveness could be dramatically improved. One of the key issues is the disparity between the locations of automatic external defibrillators and sudden cardiac arrests (SCAs). METHODS AND RESULTS: From emergency medical services and other Parisian agencies, data on all SCAs occurring in public places in Paris, France, were prospectively collected between 2000 and 2010 and recorded using 2020 grid areas. For each area, population density, population movements, and landmarks were analyzed. Of the 4176 SCAs, 1255 (30%) occurred in public areas, with a highly clustered distribution of SCAs, especially in areas containing major train stations (12% of SCAs in 0.75% of the Paris area). The association with population density was poor, with a nonsignificant increase in SCAs with population density (P=0.4). Occurrence of public SCAs was, in contrast, highly associated with population movements (P<0.001). In multivariate analysis including other landmarks in each grid cell in the model and demographic characteristics, population movement remained significantly associated with the occurrence of SCA (odds ratio, 1.48; 95% confidence interval, 1.34-1.63; P<0.0001), as well as grid cells containing train stations (odds ratio, 3.80; 95% confidence interval, 2.66-5.36; P<0.0001). CONCLUSIONS: Using a systematic analysis of determinants of SCA in public places, we demonstrated the extent to which population movements influence SCA distribution. Our findings also suggested that beyond this key risk factor, some areas are dramatically associated with a higher risk of SCA.
BACKGROUND: Although the benefits of automatic external defibrillators are undeniable, their effectiveness could be dramatically improved. One of the key issues is the disparity between the locations of automatic external defibrillators and sudden cardiac arrests (SCAs). METHODS AND RESULTS: From emergency medical services and other Parisian agencies, data on all SCAs occurring in public places in Paris, France, were prospectively collected between 2000 and 2010 and recorded using 2020 grid areas. For each area, population density, population movements, and landmarks were analyzed. Of the 4176 SCAs, 1255 (30%) occurred in public areas, with a highly clustered distribution of SCAs, especially in areas containing major train stations (12% of SCAs in 0.75% of the Paris area). The association with population density was poor, with a nonsignificant increase in SCAs with population density (P=0.4). Occurrence of public SCAs was, in contrast, highly associated with population movements (P<0.001). In multivariate analysis including other landmarks in each grid cell in the model and demographic characteristics, population movement remained significantly associated with the occurrence of SCA (odds ratio, 1.48; 95% confidence interval, 1.34-1.63; P<0.0001), as well as grid cells containing train stations (odds ratio, 3.80; 95% confidence interval, 2.66-5.36; P<0.0001). CONCLUSIONS: Using a systematic analysis of determinants of SCA in public places, we demonstrated the extent to which population movements influence SCA distribution. Our findings also suggested that beyond this key risk factor, some areas are dramatically associated with a higher risk of SCA.
Authors: Heather M Griffis; Roger A Band; Matthew Ruther; Michael Harhay; David A Asch; John C Hershey; Shawndra Hill; Lindsay Nadkarni; Austin Kilaru; Charles C Branas; Frances Shofer; Graham Nichol; Lance B Becker; Raina M Merchant Journal: Am Heart J Date: 2015-10-28 Impact factor: 4.749
Authors: Rosa Requena-Morales; Antonio Palazón-Bru; María Mercedes Rizo-Baeza; José Manuel Adsuar-Quesada; Vicente Francisco Gil-Guillén; Ernesto Cortés-Castell Journal: PLoS One Date: 2017-04-13 Impact factor: 3.240
Authors: Digna M González-Otero; Sofía Ruiz de Gauna; Jesus Ruiz; Raquel Rivero; J J Gutierrez; Purificación Saiz; James K Russell Journal: Technol Health Care Date: 2018 Impact factor: 1.285