Abstract 67: Using the Cardiac Arrest Registry to Enhance Survival to Examine Regional Variation in the Utilization of Automated External Defibrillators
Objective: To estimate the associations between demographic and event characteristics on the probability of automated external defibrillator (AED) used during an out-of-hospital cardiac arrest (OHCA) in a public location.
Methods: Design: Secondary analysis of the Cardiac Arrest Registry to Enhance Survival (CARES) dataset. Setting: CARES comprises 29 U.S. cities in 17 states with a catchment of over 22 million people. Population: Consecutive arrests restricted to those that occurred in a public location from October 1, 2005 through December 31, 2009. Data Analysis: Hierarchical logistic regression analysis using city as a random effect was used to examine the associations between demographic, event characteristics, and whether an AED was used.
Results: A total of 20,018 arrests occurred during the study period, with 4,010 arrests included in the final sample. An AED was used in 1,458 (36.4%) arrests. The percentage of bystander-applied AEDs (someone other than a first responder) was only 11.5% (n=461). The overall survival to hospital discharge for all patients included in the sample was 19.1% (n=767), while 22.5% (n=328) of those patients who had an AED used survived to hospital discharge. In the fully adjusted model, patients who were 18–34 years old (odds ratio [OR] 1.59 95% confidence interval [CI] 1.12–2.25) and male (OR 1.19; 95% CI 1.01–1.39) were more likely to have an AED used during an OHCA event. Those patients who lived in the western region were least likely of the 4 regions to have an AED used (OR 0.36; 95% CI 0.17–0.77) (Table 1).
Conclusions: There is regional variation in the utilization of AEDs in the CARES dataset. Only one out of every 10 patients who had a public arrest had an AED applied by a bystander. Further research at the city level is required to understand what is driving these variations in AED utilization. National strategies for increasing the visibility and utilization of AEDs should be considered.
- © 2010 by American Heart Association, Inc.