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Association between location of out-of-hospital cardiac arrest, on-scene socioeconomic status, and accessibility to public automated defibrillators in two large metropolitan areas in Canada and France

Abstract : Aim To 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. Methods This 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). Results A 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 400m from case vs. 67%, p<0.001) and required longer walking times to (97% above 3min vs. 91%, p<0.001) cases. In Rhône Q5 areas, AEDs were closer than in other areas (43% over 400m from case vs. 50%, p=0.01), yet similarly poorly accessible (85% above 3min vs. 86%, p=0.79). In multivariate models, AED access time ≥ 3min 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). Conclusions Accessibility of public AEDs was globally poor in Metro Vancouver and Rhône, and even poorer in Metro Vancouver’s socioeconomically deprived areas.
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https://hal-univ-lyon1.archives-ouvertes.fr/hal-03834681
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Submitted on : Sunday, October 30, 2022 - 9:03:11 PM
Last modification on : Monday, October 31, 2022 - 3:36:46 AM

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Matthieu Heidet, Julie Freyssenge, Clément Claustre, John Deakin, Jennie Helmer, et al.. Association between location of out-of-hospital cardiac arrest, on-scene socioeconomic status, and accessibility to public automated defibrillators in two large metropolitan areas in Canada and France. Resuscitation, 2022, ⟨10.1016/j.resuscitation.2022.10.016⟩. ⟨hal-03834681⟩

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