• Resuscitation · Oct 2024

    Observational Study

    Association between bystander automated external defibrillator use and survival in witnessed out-of-hospital cardiac arrest: A nationwide observational study in South Korea.

    • Jang Yeong Heo, Young Taeck Oh, Jae Hwan Kim, Chiwon Ahn, Mi Suk Yang, Chan Woong Kim, and Sung Eun Kim.
    • Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea.
    • Resuscitation. 2024 Oct 1; 203: 110388110388.

    AimSudden cardiac arrest is a global health issue, with out-of-hospital cardiac arrest (OHCA) posing a major challenge. Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) improve survival and neurological outcomes. However, their actual usage involves numerous constraints. Therefore, to determine the association between bystander AED use and survival of patients with OHCA, we analyzed South Korea's national OHCA database.MethodsThis retrospective study included cases from the Korea Disease Control and Prevention Agency's Out-of-Hospital Cardiac Arrest Surveillance database from January 2016 to December 2021. Adult OHCA cases treated with bystander intervention were categorized into two groups, CPR with AEDs and without AEDs. Propensity score matching was employed to control for confounders and analyze bystander AED use's impact on survival to discharge and neurological outcomes.ResultsOf 182,508 OHCA cases, 35,840 met the inclusion criteria, with 234 (0.7%) receiving bystander CPR with AEDs. The survival rate to discharge in the AED and non-AED group was 46.6% and 23.0%, respectively. However, after adjusting for potential confounders, bystander AED use did not significantly affect survival to discharge (adjusted odds ratio [aOR] 1.01, 95% confidence interval [CI] 0.70-1.44) or favorable neurological outcomes (aOR 1.08, 95% CI 0.99-1.18).ConclusionSurvival to discharge or favorable neurological outcomes of patients with OHCA managed using bystander-applied AEDs and those without showed no significant difference. Factors such as AED accessibility and bystander preparedness influence the impact of bystander AED use. Further research should optimize AED deployment and usage strategies to enhance patient survival rate.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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