Abstract 16267: Identifying Hot Spots for EMS-Treated Acute Cardiovascular Events - Stroke, STEMI, and Cardiac Arrest - In a Large Metropolitan City
Introduction: Time sensitive cardiovascular diseases - stroke, STEMI, and cardiac arrest - require an integrated system of lay person, emergency medical services (EMS), and hospital-based care to deliver prompt therapies and improve outcomes. Geographic Information Systems (GIS) represents an emerging methodology for matching clinical to spatial metrics to inform intervention and policy development. The Chicago EMS System is one of the largest and busiest in the United States, a fire-based 911 model with over 380,000 EMS responses annually in the nation’s third most populous city. Chicago has implemented systems of care for stroke, STEMI, and cardiac arrest.
Methods: In a retrospective review, scene coordinates (latitude and longitude) for all patients triaged by on-scene treating paramedics as a 1) prehospital stroke, 2) STEMI, and 3) non-traumatic out-of-hospital cardiac arrest between May 15, 2012 and May 3, 2013 were obtained. Cases were identified from the Chicago Fire Department electronic medical record. Using GIS software (ESRI’s ArcGIS 10.1) and the Getis-Ord Gi* method, we mapped statistical “hot spots” for each disease. Hot spots are defined as areas where high values of a phenomena spatially cluster. Maps represent the hot spots (and cold spots) for each condition superimposed on a map of Chicago.
Results: During the study period, there were 1,579 strokes, 2,235 non-traumatic cardiac arrests, and 398 STEMIs. While there were overlapping hot and cold spots for the three conditions, differences were also apparent. Neighborhoods in the south and west sides of Chicago were hot spots for all three conditions.
Conclusion: Discrete areas within Chicago were identified as hot spots for EMS-treated stroke, STEMI, and cardiac arrest. GIS mapping and hot spot analysis of prehospital time critical conditions can be valuable for community outreach to mitigate health disparities, operational deployment of EMS resources, and targeted performance improvement.
- © 2013 by American Heart Association, Inc.