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Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA)

BACKGROUND: Ambulance response times and resuscitation efforts are critical predictors of the survival rate after out-of-hospital cardiac arrests (OHCA). On the other hand, rural-urban differences in the OHCA survival rates are an important public health issue. METHODS: We retrospectively reviewed t...

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Autores principales: Chen, Chien-Chou, Chen, Chao-Wen, Ho, Chi-Kung, Liu, I-Chuan, Lin, Bo-Cheng, Chan, Ta-Chien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682793/
https://www.ncbi.nlm.nih.gov/pubmed/26659851
http://dx.doi.org/10.1371/journal.pone.0144882
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author Chen, Chien-Chou
Chen, Chao-Wen
Ho, Chi-Kung
Liu, I-Chuan
Lin, Bo-Cheng
Chan, Ta-Chien
author_facet Chen, Chien-Chou
Chen, Chao-Wen
Ho, Chi-Kung
Liu, I-Chuan
Lin, Bo-Cheng
Chan, Ta-Chien
author_sort Chen, Chien-Chou
collection PubMed
description BACKGROUND: Ambulance response times and resuscitation efforts are critical predictors of the survival rate after out-of-hospital cardiac arrests (OHCA). On the other hand, rural-urban differences in the OHCA survival rates are an important public health issue. METHODS: We retrospectively reviewed the January 2011–December 2013 OHCA registry data of Kaohsiung City, Taiwan. With particular focus on geospatial variables, we aimed to unveil risk factors predicting the overall OHCA survival until hospital admission. Spatial analysis, network analysis, and the Kriging method by using geographic information systems were applied to analyze spatial variations and calculate the transport distance. Logistic regression was used to identify the risk factors for OHCA survival. RESULTS: Among the 4,957 patients, the overall OHCA survival to hospital admission was 16.5%. In the multivariate analysis, female sex (adjusted odds ratio:, AOR, 1.24 [1.06–1.45]), events in public areas (AOR: 1.30 [1.05–1.61]), exposure to automated external defibrillator (AED) shock (AOR: 1.70 [1.30–2.23]), use of laryngeal mask airway (LMA) (AOR: 1.35 [1.16–1.58]), non-trauma patients (AOR: 1.41 [1.04–1.90]), ambulance bypassed the closest hospital (AOR: 1.28 [1.07–1.53]), and OHCA within the high population density areas (AOR: 1.89 [1.55–2.32]) were positively associated with improved OHCA survival. By contrast, a prolonged total emergency medical services (EMS) time interval was negatively associated with OHCA survival (AOR: 0.98 [0.96–0.99]). CONCLUSIONS: Resuscitative efforts, such as AED or LMA use, and a short total EMS time interval improved OHCA outcomes in emergency departments. The spatial heterogeneity of emergency medical resources between rural and urban areas might affect survival rate.
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spelling pubmed-46827932015-12-31 Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA) Chen, Chien-Chou Chen, Chao-Wen Ho, Chi-Kung Liu, I-Chuan Lin, Bo-Cheng Chan, Ta-Chien PLoS One Research Article BACKGROUND: Ambulance response times and resuscitation efforts are critical predictors of the survival rate after out-of-hospital cardiac arrests (OHCA). On the other hand, rural-urban differences in the OHCA survival rates are an important public health issue. METHODS: We retrospectively reviewed the January 2011–December 2013 OHCA registry data of Kaohsiung City, Taiwan. With particular focus on geospatial variables, we aimed to unveil risk factors predicting the overall OHCA survival until hospital admission. Spatial analysis, network analysis, and the Kriging method by using geographic information systems were applied to analyze spatial variations and calculate the transport distance. Logistic regression was used to identify the risk factors for OHCA survival. RESULTS: Among the 4,957 patients, the overall OHCA survival to hospital admission was 16.5%. In the multivariate analysis, female sex (adjusted odds ratio:, AOR, 1.24 [1.06–1.45]), events in public areas (AOR: 1.30 [1.05–1.61]), exposure to automated external defibrillator (AED) shock (AOR: 1.70 [1.30–2.23]), use of laryngeal mask airway (LMA) (AOR: 1.35 [1.16–1.58]), non-trauma patients (AOR: 1.41 [1.04–1.90]), ambulance bypassed the closest hospital (AOR: 1.28 [1.07–1.53]), and OHCA within the high population density areas (AOR: 1.89 [1.55–2.32]) were positively associated with improved OHCA survival. By contrast, a prolonged total emergency medical services (EMS) time interval was negatively associated with OHCA survival (AOR: 0.98 [0.96–0.99]). CONCLUSIONS: Resuscitative efforts, such as AED or LMA use, and a short total EMS time interval improved OHCA outcomes in emergency departments. The spatial heterogeneity of emergency medical resources between rural and urban areas might affect survival rate. Public Library of Science 2015-12-14 /pmc/articles/PMC4682793/ /pubmed/26659851 http://dx.doi.org/10.1371/journal.pone.0144882 Text en © 2015 Chen et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Chen, Chien-Chou
Chen, Chao-Wen
Ho, Chi-Kung
Liu, I-Chuan
Lin, Bo-Cheng
Chan, Ta-Chien
Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA)
title Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA)
title_full Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA)
title_fullStr Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA)
title_full_unstemmed Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA)
title_short Spatial Variation and Resuscitation Process Affecting Survival after Out-of-Hospital Cardiac Arrests (OHCA)
title_sort spatial variation and resuscitation process affecting survival after out-of-hospital cardiac arrests (ohca)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682793/
https://www.ncbi.nlm.nih.gov/pubmed/26659851
http://dx.doi.org/10.1371/journal.pone.0144882
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