Bridget Dicker1, Nick Garrett2, Samuel Wong3, Helen McKenzie4, John McCarthy5, Gareth Jenkin6, Tony Smith3, Jonathan R Skinner7, Tammy Pegg8, Gerry Devlin9, Andrew Swain10, Tony Scott11, Verity Todd12. 1. Paramedicine Department, Auckland University of Technology, Auckland, New Zealand; Clinical Audit and Research, St John New Zealand, Auckland, New Zealand. Electronic address: bridget.dicker@stjohn.org.nz. 2. Biostatistics and Epidemiology Department, Auckland University of Technology, Auckland, New Zealand. 3. Clinical Audit and Research, St John New Zealand, Auckland, New Zealand. 4. Northern Regional Alliance, Auckland, New Zealand. 5. Ministry of Health, Wellington, New Zealand. 6. AED Locations, Auckland, New Zealand. 7. Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand. 8. Cardiology, Nelson Marlborough District Health Board, Nelson, New Zealand. 9. Gisbourne Hospital, Tairāwhiti District Health, Gisbourne, New Zealand; Heart Foundation NZ, Auckland, New Zealand. 10. Paramedicine Department, Auckland University of Technology, Auckland, New Zealand. 11. Cardiology, Waitemata District Health Board, Auckland, New Zealand. 12. Paramedicine Department, Auckland University of Technology, Auckland, New Zealand; Clinical Audit and Research, St John New Zealand, Auckland, New Zealand.
Abstract
BACKGROUND: Survival from out-of-hospital cardiac arrest (OHCA) is improved when public access defibrillators are used. Areas of socioeconomic deprivation may have higher rates of OHCA and thus a greater demand for public access defibrillators. We aimed to determine if there was a relationship between socioeconomic factors, the geographic distribution of public access defibrillators (PADs) and incidence of OHCA. METHOD: Socioeconomic deprivation data was obtained from the Census-based 2013 Index of Deprivation. Spatial information for PADs was obtained from a New Zealand PAD database (AED Locations) in 2016 and 2018. Location data for OHCA was obtained from the St John New Zealand OHCA registry for the period 1 October 2013 to 30 June 2016. Relationships between these variables were analysed using a Poisson regression analysis. RESULTS: Cardiac arrest incidence increased with increasing deprivation. The incidence in the most deprived areas of 156.5 events per 100,000 person years (135.4-180.9, 95% CI) is double the incidence in the least deprived areas at 78.0 events per 100,000 person years (66.4-91.7, 95% CI). Significant increases in the rates of OHCA were observed with every 1% increase in proportions of Māori (1.0%, 0.61-1.4%, 95% CI, p = 0.001), Pacific Peoples (0.6%, 0.21-0.9%, p = 0.005), >65 year olds (3.7%, 3.0-4.3%, p < 0.001), and males (3.7%, 1.8-5.6%, p < 0.001). In 2018, the decile 10 areas had the lowest coverage of PADs (65% of these areas contained a PAD) compared with less deprived areas (68-84%, median 81%). CONCLUSIONS: The most socioeconomically deprived communities had the highest incidence of OHCA and the least availability of PADs. This provides impetus for targeted PAD placement in areas of higher deprivation.
BACKGROUND: Survival from out-of-hospital cardiac arrest (OHCA) is improved when public access defibrillators are used. Areas of socioeconomic deprivation may have higher rates of OHCA and thus a greater demand for public access defibrillators. We aimed to determine if there was a relationship between socioeconomic factors, the geographic distribution of public access defibrillators (PADs) and incidence of OHCA. METHOD: Socioeconomic deprivation data was obtained from the Census-based 2013 Index of Deprivation. Spatial information for PADs was obtained from a New Zealand PAD database (AED Locations) in 2016 and 2018. Location data for OHCA was obtained from the St John New Zealand OHCA registry for the period 1 October 2013 to 30 June 2016. Relationships between these variables were analysed using a Poisson regression analysis. RESULTS:Cardiac arrest incidence increased with increasing deprivation. The incidence in the most deprived areas of 156.5 events per 100,000 person years (135.4-180.9, 95% CI) is double the incidence in the least deprived areas at 78.0 events per 100,000 person years (66.4-91.7, 95% CI). Significant increases in the rates of OHCA were observed with every 1% increase in proportions of Māori (1.0%, 0.61-1.4%, 95% CI, p = 0.001), Pacific Peoples (0.6%, 0.21-0.9%, p = 0.005), >65 year olds (3.7%, 3.0-4.3%, p < 0.001), and males (3.7%, 1.8-5.6%, p < 0.001). In 2018, the decile 10 areas had the lowest coverage of PADs (65% of these areas contained a PAD) compared with less deprived areas (68-84%, median 81%). CONCLUSIONS: The most socioeconomically deprived communities had the highest incidence of OHCA and the least availability of PADs. This provides impetus for targeted PAD placement in areas of higher deprivation.
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: Felipe Teran; Sarah M Perman; Oscar J L Mitchell; Kelly N Sawyer; Audrey L Blewer; Jon C Rittenberger; Marina Del Rios Rivera; James M Horowitz; Joseph E Tonna; Cindy H Hsu; Pavitra Kotini-Shah; Shaun K McGovern; Benjamin S Abella Journal: J Am Heart Assoc Date: 2020-05-12 Impact factor: 5.501