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AEDs improve survival after out-of-hospital cardiac arrest

Wider use of automated external defibrillators (AEDs) is associated with increased survival in patients with a shockable initial rhythm after out-of-hospital cardiac arrest, according to a study published recently in Circulation.1

Authors from the Netherlands performed a population-based cohort study, including patients with out-of-hospital cardiac arrest from cardiac causes between 2006 and 2012, excluding emergency medical service-witnessed arrests. They determined survival status at each stage (to emergency department, to admission, and to discharge) and examined temporal trends using logistic regression analysis with year of resuscitation as an independent variable.

By adding each co-variable subsequently to the regression model, they investigated the impact of each on the odds ratio of year of resuscitation. Analyses were performed according to initial rhythm (shockable vs. nonshockable) and AED use.

Rates of survival with favourable neurologic outcome after out-of-hospital cardiac arrest increased significantly (N=6133, 16.2% to 19.7%; P for trend=0.021), although solely in patients presenting with a shockable initial rhythm (N=2823; 29.1% to 41.4%; P for trend<0.001). In this group, survival increased at each stage but was strongest in the pre-hospital phase (odds ratio, 1.11 [95% CI, 1.06–1.16]).

7 - Improved Survival After Out-of-Hospital Cardiac Arrest and Use of Automated External DefibrillatorsRates of AED use almost tripled during the study period (21.4% to 59.3%; P for trend <0.001), thereby decreasing time from emergency call to defibrillation-device connection (median, 9.9 to 8.0 minutes; P<0.001). AED use statistically explained increased survival with favourable neurologic outcome by decreasing the odds ratio of year of resuscitation to a non-significant 1.04.

Continuous efforts should be made to introduce or extend AED programmes, the authors conclude.

References

1. Blom MT, Beesems SG, Homma PCM, et al. Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation 2014;130:1868–75. http://dx.doi.org/10.1161/CIRCULATIONAHA.114.010905

Published on: December 19, 2014

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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