• Matthieu Heidet, Julie Freyssenge, Clément Claustre, John Deakin, Jennie Helmer, Bruno Thomas-Lamotte, Mathys Wohl, Li Danny Liang, Hervé Hubert, Valentine Baert, Christian Vilhelm, Laurie Fraticelli, Éric Mermet, Axel Benhamed, François Revaux, Éric Lecarpentier, Guillaume Debaty, Karim Tazarourte, Sheldon Cheskes, Jim Christenson, Carlos El Khoury, Brian Grunau, and RéAC, CanROC, ReACanROC investigators.
• Assistance Publique - Hôpitaux de Paris (AP-HP), SAMU 94 and Emergency Department, Hôpitaux universitaires Henri Mondor, Créteil, France; Université Paris-Est Créteil (UPEC), EA-3956 (Control in Intelligent Networks [CIR]), Créteil, France. Electronic address: matthieu.heidet@aphp.fr.
• Resuscitation. 2022 Dec 1; 181: 9710997-109.

AimTo compare walking access times to automated external defibrillators (AEDs) between area-level quintiles of socioeconomic status (SES) in out-of-hospital cardiac arrest (OHCA) cases occurring in 2 major urban regions of Canada and France.MethodsThis was an international, multicenter, retrospective cohort study of adult, non-traumatic OHCA cases in the metropolitan Vancouver (Canada) and Rhône County (France) regions that occurred between 2014 and 2018. We calculated area-level SES for each case, using quintiles of country-specific scores (Q5 = most deprived). We identified AED locations from local registries. The primary outcome was the simulated walking time from the OHCA location to the closest AED (continuous and dichotomized by a 3-minute 1-way threshold). We fit multivariate models to analyze the association between OHCA-to-AED walking time and outcomes (Q5 vs others).ResultsA total of 6,187 and 3,239 cases were included from the Metro Vancouver and Rhône County areas, respectively. In Metro Vancouver Q5 areas (vs Q1-Q4), areas, AEDs were farther from (79 % over 400 m from case vs 67 %, p < 0.001) and required longer walking times to (97 % above 3 min vs 91 %, p < 0.001) cases. In Rhône Q5 areas, AEDs were closer than in other areas (43 % over 400 m from case vs 50 %, p = 0.01), yet similarly poorly accessible (85 % above 3 min vs 86 %, p = 0.79). In multivariate models, AED access time ≥ 3 min was associated with decreased odds of survival at hospital discharge in Metro Vancouver (odds ratio 0.41, 95 % CI [0.23-0.74], p = 0.003).ConclusionsAccessibility of public AEDs was globally poor in Metro Vancouver and Rhône, and even poorer in Metro Vancouver's socioeconomically deprived areas.Copyright © 2022 Elsevier B.V. All rights reserved.

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