• Int. J. Cardiol. · Jan 2020

    Public-access automated external defibrillator pad application and favorable neurological outcome after out-of-hospital cardiac arrest in public locations: A prospective population-based propensity score-matched study.

    • Takefumi Kishimori, Takeyuki Kiguchi, Kosuke Kiyohara, Tasuku Matsuyama, Haruka Shida, Chika Nishiyama, Daisuke Kobayashi, Satoe Okabayashi, Tomonari Shimamoto, Sumito Hayashida, Tetsuhisa Kitamura, Takashi Kawamura, and Taku Iwami.
    • Department of Preventive Services, Kyoto University Graduate School of Medicine, Kyoto, Japan.
    • Int. J. Cardiol. 2020 Jan 15; 299: 140-146.

    BackgroundRandomized controlled trials or observational studies showed that the use of public-access automated external defibrillator (AED) was effective for patients with out-of-hospital cardiac arrest (OHCA). However, it is unclear whether public-access AED use is effective for all patients with OHCA irrespective of first documented rhythm. We aimed to evaluate the effect of public-access AED use for OHCA patients considering first documented rhythm (shockable or non-shockable) in public locations.MethodsFrom the Utstein-style registry in Osaka City, Japan, we obtained information on adult patients with OHCA of medical origin in public locations before emergency-medical-service personnel arrival between 2011 and 2015. Primary outcome was 1-month survival with favorable neurological outcome. Multivariable logistic regression analysis was performed to assess the association between the public-access AED pad application and favorable neurological outcome after OHCA by using one-to-one propensity score matching analysis.ResultsAmong 1743 eligible patients, a total of 336 (19.3%) patients received public-access AED pad application. The proportion of patients who survived 1-month with favorable neurological outcome was significantly higher in the pad application group than in the non-pad application group (29.8% vs. 9.7%; adjusted odds ratio [AOR], 2.85; 95% confidence interval [CI], 1.73-4.68, AOR after propensity score matching, 2.46; 95% CI, 1.29-4.68). In a subgroup analysis, the AORs of patients with shockable or non-shockable rhythms were 3.36 (95% CI, 1.78-6.35) and 2.38 (95% CI, 0.89-6.34), respectively.ConclusionsPublic-access AED pad application was associated with better outcome among patients with OHCA of medical origin in public locations irrespective of first documented rhythm.Copyright © 2019 Elsevier B.V. All rights reserved.

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