Abstract 16207: Public Access to Defibrillation, Population Education in Basic Life Support, and Survival From Sudden Cardiac Arrest in the Community
Background: Public access to defibrillation has been associated with better survival after sudden cardiac arrest (SCA) in the community. However, the extent to which the effect is related to the deployment of automatic external defibrillators (AEDs) is unclear. SCA during sporting activities offers a particularly suitable setting to address this issue.
Hypothesis: In the community, the interest of AED deployment is not only related to higher proportion of early defibrillation.
Methods: Observational national prospective national French survey (2005-2010), carried out in sixty French administrative regions (covering a population of 35 million), of subjects 10-75 years old presenting with SCA during sport with an independent and blinded assessment of the deployment of AEDs and community education to basic life support in each districts. Survival rates at hospital discharge were determined in each participating region, and finally four groups of survival were prospectively defined. Associations between survival from SCA (hospital discharge), deployment of AEDs, and population education in basic life support were studied.
Results: Of the 820 consecutive cases of SCA during sports among 10-75 year olds in the general population, there were major regional disparities in survival to hospital discharge after SCA (from a low of 3.4 to a high of 42.7%). Overall the deployment of AEDs available as well as education of the population in basic life support both increased significantly with survival (P<0.001). However, the number of patients actually receiving defibrillation by bystanders was extremely low (<1%), and did not differ between survival groups (P=0.74). In multivariate analysis, after adjustment for individual prognostic factors, only the level of population education was significantly associated with survival at hospital discharge (OR 1.64, 95% CI 1.17-2.31, P=0.0045).
Conclusions: There is a highly significant association between AEDs deployment and survival after SCA. However, our results strongly suggest that this association is mainly confounded by public education in basic life support. These results are of particular interest to finally increase cost-effectiveness of public access to defibrillation programs.
- © 2013 by American Heart Association, Inc.