Relationship Between Socioeconomic Factors, Distribution of Public Access Defibrillators and Incidence of Out-of-hospital Cardiac Arrest

Dicker, B
Garrett, N
Wong, S
McKenzie, H
McCarthy, J
Jenkin, G
Smith, T
Skinner, JR
Pegg, T
Devlin, G
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Background: Survival from out-of-hospital cardiac arrest (OHCA) is improved when public access defibrillators are used. Areas of socioeconomic deprivation may have higher rates of OHCA and thus a greater demand for public access defibrillators. We aimed to determine if there was a relationship between socioeconomic factors, the geographic distribution of public access defibrillators (PADs) and incidence of OHCA. Method: Socioeconomic deprivation data was obtained from the Census-based 2013 Index of Deprivation. Spatial information for PADs was obtained from a New Zealand PAD database (AED Locations) in 2016 and 2018. Location data for OHCA was obtained from the St John New Zealand OHCA registry for the period 1 October 2013 to 30 June 2016. Relationships between these variables were analysed using a Poisson regression analysis. Results: Cardiac arrest incidence increased with increasing deprivation. The incidence in the most deprived areas of 156.5 events per 100,000 person years (135.4–180.9, 95% CI) is double the incidence in the least deprived areas at 78.0 events per 100,000 person years (66.4–91.7, 95% CI). Significant increases in the rates of OHCA were observed with every 1% increase in proportions of Māori (1.0%, 0.61–1.4%, 95% CI, p = 0.001), Pacific Peoples (0.6%, 0.21–0.9%, p = 0.005), >65 year olds (3.7%, 3.0–4.3%, p < 0.001), and males (3.7%, 1.8–5.6%, p < 0.001). In 2018, the decile 10 areas had the lowest coverage of PADs (65% of these areas contained a PAD) compared with less deprived areas (68–84%, median 81%). Conclusions: The most socioeconomically deprived communities had the highest incidence of OHCA and the least availability of PADs. This provides impetus for targeted PAD placement in areas of higher deprivation.

Automated external defibrillator (AED); Public access defibrillator (PAD); Out-of-hospital cardiac arrest (OHCA); Deprivation; Ethnicity; Resuscitation; Bystander; Defibrillation; Cardiopulmonary resuscitation
Resuscitation, 138, 53-58.
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