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

研究成果: Article査読

42 被引用数 (Scopus)

抄録

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.

本文言語English
論文番号26
ジャーナルInternational Journal of Health Geographics
10
DOI
出版ステータスPublished - 2011 4 14

ASJC Scopus subject areas

  • コンピュータ サイエンス(全般)
  • ビジネス、管理および会計(全般)
  • 公衆衛生学、環境および労働衛生

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