Lena Karlsson1, Carolina Malta Hansen2, Mads Wissenberg3, Steen Møller Hansen4, Freddy K Lippert5, Shahzleen Rajan6, Kristian Kragholm7, Sidsel G Møller6, Kathrine Bach Søndergaard6, Gunnar H Gislason8, Christian Torp-Pedersen9, Fredrik Folke3. 1. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Emergency Medical Services Copenhagen, University of Copenhagen, Denmark. Electronic address: limkarlsson@gmail.com. 2. Emergency Medical Services Copenhagen, University of Copenhagen, Denmark; Department of Cardiology, Nephrology, and Endocrinology, Copenhagen University Hospital Hillerød, The Region of Northern Zealand, Denmark. 3. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Emergency Medical Services Copenhagen, University of Copenhagen, Denmark. 4. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark. 5. Emergency Medical Services Copenhagen, University of Copenhagen, Denmark. 6. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. 7. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. 8. Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 9. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; The Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Abstract
AIMS: Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations. METHODS: In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located ≤200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival. RESULTS: Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, <50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible: 13.8% vs. inaccessible: 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible: 28.8% vs. inaccessible: 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss >50%, due to limited AED accessibility. CONCLUSIONS: The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.
AIMS: Optimization of automated external defibrillator (AED) placement and accessibility are warranted. We examined the associations between AED accessibility, at the time of an out-of-hospital cardiac arrest (OHCA), bystander defibrillation, and 30-day survival, as well as AED coverage according to AED locations. METHODS: In this registry-based study we identified all OHCAs registered by mobile emergency care units in Copenhagen, Denmark (2008-2016). Information regarding registered AEDs (2007-2016) was retrieved from the nationwide Danish AED Network. We calculated AED coverage (AEDs located ≤200 m route distance from an OHCA) and, according to AED accessibility, the likelihoods of bystander defibrillation and 30-day survival. RESULTS: Of 2500 OHCAs, 22.6% (n = 566) were covered by a registered AED. At the time of OHCA, <50% of these AEDs were accessible (n = 276). OHCAs covered by an accessible AED were nearly three times more likely to receive bystander defibrillation (accessible: 13.8% vs. inaccessible: 4.8%, p < 0.001) and twice as likely to achieve 30-day survival (accessible: 28.8% vs. inaccessible: 16.4%, p < 0.001). Among bystander-witnessed OHCAs with shockable heart rhythms (accessible vs. inaccessible AEDs), bystander defibrillation rates were 39.8% vs. 20.3% (p = 0.01) and 30-day survival rates were 72.7% vs. 44.1% (p < 0.001). Most OHCAs were covered by AEDs at offices (18.6%), schools (13.3%), and sports facilities (12.9%), each with a coverage loss >50%, due to limited AED accessibility. CONCLUSIONS: The chance of a bystander defibrillation was tripled, and 30-day survival nearly doubled, when the nearest AED was accessible, compared to inaccessible, at the time of OHCA, underscoring the importance of unhindered AED accessibility.
Authors: Lena Karlsson; Carolina Malta Hansen; Mads Wissenberg; Steen Møller Hansen; Freddy K Lippert; Shahzleen Rajan; Kristian Kragholm; Sidsel G Møller; Kathrine Bach Søndergaard; Gunnar H Gislason; Christian Torp-Pedersen; Fredrik Folke Journal: Data Brief Date: 2019-04-29
Authors: Terry P Brown; Gavin D Perkins; Christopher M Smith; Charles D Deakin; Rachael Fothergill Journal: Resuscitation Date: 2021-10-29 Impact factor: 5.262
Authors: Katarina Høgh Mottlau; Linn Charlotte Andelius; Rasmus Gregersen; Carolina Malta Hansen; Fredrik Folke Journal: J Am Heart Assoc Date: 2022-01-21 Impact factor: 6.106
Authors: Christopher L F Sun; Lena Karlsson; Laurie J Morrison; Steven C Brooks; Fredrik Folke; Timothy C Y Chan Journal: J Am Heart Assoc Date: 2020-08-20 Impact factor: 5.501
Authors: Sidsel G Møller; Shahzleen Rajan; Steen Møller-Hansen; Kristian Kragholm; Kristian B Ringgren; Fredrik Folke; Carolina Malta Hansen; Freddy K Lippert; Lars Køber; Gunnar Gislason; Christian Torp-Pedersen; Mads Wissenberg Journal: Resusc Plus Date: 2020-11-04