Population density, call-response interval, and survival of out-of-hospital cardiac arrest

Hideo Yasunaga, Hiroaki Miyata, Hiromasa Horiguchi, Seizan Tanabe, Manabu Akahane, Toshio Ogawa, Soichi Koike, Tomoaki Imamura

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Little is known about the effects of geographic variation on outcomes of out-of-hospital cardiac arrest (OHCA). The present study investigated the relationship between population density, time between emergency call and ambulance arrival, and survival of OHCA, using the All-Japan Utstein-style registry database, coupled with geographic information system (GIS) data.Methods: We examined data from 101,287 bystander-witnessed OHCA patients who received emergency medical services (EMS) through 4,729 ambulatory centers in Japan between 2005 and 2007. Latitudes and longitudes of each center were determined with address-match geocoding, and linked with the Population Census data using GIS. The endpoints were 1-month survival and neurologically favorable 1-month survival defined as Glasgow-Pittsburgh cerebral performance categories 1 or 2.Results: Overall 1-month survival was 7.8%. Neurologically favorable 1-month survival was 3.6%. In very low-density (<250/km2) and very high-density (≥10,000/km2) areas, the mean call-response intervals were 9.3 and 6.2 minutes, 1-month survival rates were 5.4% and 9.1%, and neurologically favorable 1-month survival rates were 2.7% and 4.3%, respectively. After adjustment for age, sex, cause of arrest, first aid by bystander and the proportion of neighborhood elderly people ≥65 yrs, patients in very high-density areas had a significantly higher survival rate (odds ratio (OR), 1.64; 95% confidence interval (CI), 1.44 - 1.87; p < 0.001) and neurologically favorable 1-month survival rate (OR, 1.47; 95%CI, 1.22 - 1.77; p < 0.001) compared with those in very low-density areas.Conclusion: Living in a low-density area was associated with an independent risk of delay in ambulance response, and a low survival rate in cases of OHCA. Distribution of EMS centers according to population size may lead to inequality in health outcomes between urban and rural areas.

Original languageEnglish
Article number26
JournalInternational Journal of Health Geographics
Volume10
DOIs
Publication statusPublished - 2011 Apr 14
Externally publishedYes

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Out-of-Hospital Cardiac Arrest
Population Density
Survival Rate
Ambulances
Survival
Geographic Information Systems
Geographic information systems
Emergency Medical Services
Japan
Geographic Mapping
Odds Ratio
Confidence Intervals
First Aid
Censuses
Health
Registries
Emergencies
Population density
Survival rate
Databases

ASJC Scopus subject areas

  • Computer Science(all)
  • Business, Management and Accounting(all)
  • Public Health, Environmental and Occupational Health

Cite this

Population density, call-response interval, and survival of out-of-hospital cardiac arrest. / Yasunaga, Hideo; Miyata, Hiroaki; Horiguchi, Hiromasa; Tanabe, Seizan; Akahane, Manabu; Ogawa, Toshio; Koike, Soichi; Imamura, Tomoaki.

In: International Journal of Health Geographics, Vol. 10, 26, 14.04.2011.

Research output: Contribution to journalArticle

Yasunaga, Hideo ; Miyata, Hiroaki ; Horiguchi, Hiromasa ; Tanabe, Seizan ; Akahane, Manabu ; Ogawa, Toshio ; Koike, Soichi ; Imamura, Tomoaki. / Population density, call-response interval, and survival of out-of-hospital cardiac arrest. In: International Journal of Health Geographics. 2011 ; Vol. 10.
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AU - Yasunaga, Hideo

AU - Miyata, Hiroaki

AU - Horiguchi, Hiromasa

AU - Tanabe, Seizan

AU - Akahane, Manabu

AU - Ogawa, Toshio

AU - Koike, Soichi

AU - Imamura, Tomoaki

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