Population Movement and Sudden Cardiac Arrest Location
Background—Although the benefits of Automatic External Defibrillators (AEDs) are undeniable, their effectiveness could be dramatically improved. One of the key issues is the disparity between the location of AEDs and Sudden Cardiac Arrest (SCA).
Methods and Results—From Emergency Medical Services and other Parisian agencies, data on all SCAs occurring in public places in Paris, France were prospectively collected between 2000 and 2010, and recorded using 2,020 grid areas. For each area, population density, population movements, and landmarks were analyzed. Of the 4,176 SCA, 1,255 (30%) occurred in public areas, with a highly clustered distribution of SCA, especially in areas containing major train stations (12% of SCAs in 0.75% of the Paris area). The association with population density was poor, with a non-significant increase of SCA with population density (P=0.4). Occurrence of public SCAs was, by contrast, highly associated with population movements (P<0.001). In multivariate analysis, including other landmarks in each grid-cell in the model and demographic characteristics, population movement remained significantly associated with occurrence of SCA (OR 1.48, 95%IC 1.34-1.63, P < 0.0001), as well as grid-cells containing train stations (OR 3.80, 95%CI 2.66-5.36, P<0.0001).
Conclusions—Using a systematic analysis of determinants of SCA in public places, we demonstrated the extent to which population movements influence SCA distribution. Our findings also suggested that beyond this key risk factor, some areas are dramatically associated with a higher risk of SCA.
- Sudden death
- sudden cardiac arrest
- automated external defibrillator
- cardiopulmonary resuscitation
- Received April 7, 2014.
- Revision received February 12, 2015.
- Accepted February 26, 2015.