Abstract 244: Cardiac Arrests Among Higher Population Density Are Associated with Higher Rates of Return of Spontaneous Circulation but Not Survival
BACKGROUND: Previous studies from Japan and Australia have measured significantly decreased survival associated with lower population density. We sought to measure the effect, if any, of population density on survival in the state of Utah, which has a dense urban corridor surrounded by large geographic areas of low population density.
METHODS: We analyzed a prospectively-collected registry of all cardiac arrests in the state of Utah between July 1, 2012 through December 31, 2013. We used 2010 census records to assign a population density to incident zip codes. Logistic regression was used to determine the effect of population density on sustained return of spontaneous circulation (ROSC), survival to hospital discharge, and neurologically-intact survival.
RESULTS: During the study period, 422/1,534 (27.5%) OHCA victims survived to hospital admission. 670 (44%) arrests occurred in locations with a population density <1,000 people/mile2. There were no significant differences in mean age, rates of witnessed arrest, shockable rhythms, or bystander CPR between quartiles of population density. Logistic regression demonstrated higher rates of ROSC (OR 1.07 per every 1,000 people/ mile2, 95% CI 1.01-1.13) while controlling for Utstein variables (TABLE). However, there was no association between population density and survival to hospital discharge (OR 1.04, 95% CI 0.96-1.13) nor rates of neurologically-intact survival (OR 1.03, 95% CI 0.94-1.12).
CONCLUSIONS: In this statewide database, we found a positive association between population density and ROSC but not survival. These results are counterintuitive but suggest that urban vs rural disparities in cardiac arrest survival are not as large in the state of Utah.
Author Disclosures: H. Stoecklein: None. C. Stratford: None. P. Taillac: None. S. Youngquist: Speakers Bureau; Modest; Physio-Control. Consultant/Advisory Board; Modest; Keytechnic.
- © 2014 by American Heart Association, Inc.