Automated external defibrillator use and outcomes after out-of-hospital cardiac arrest: an Israeli cohort study

Coron Artery Dis. 2020 May;31(3):289-292. doi: 10.1097/MCA.0000000000000807.

Abstract

Background: Out-of-hospital cardiac arrests (OHCA) are a serious healthcare situation with low survival rates. Application of an automated external defibrillator (AED) by bystanders shortens time to defibrillation and increases survival. In Israel, a regulation ensuring the presence of AED in public places was issued and implemented since 2014. We investigated whether this regulation had an impact on the outcomes of OHCA patients.

Methods: We performed a retrospective, single-center observational study. Included in the cohort were patients who were admitted to the department of intensive care cardiac unit with OHCA. Patients were stratified into two groups according to the year the regulation was introduced: group 1 (2009-2013) and group 2 (2014-2018).

Results: A total of 77 patients were included in group 1 and 61 in group 2. The utilization of AED was significantly higher in group 2 compared to group 1 (42% vs. 27%; P = 0.04). Compared to group 1 patients, group 2 had lower 48 h (0% vs. 8%; P = 0.02) and 30-day mortality (28% vs. 42%; P = 0.02). Cognitive damage following recovery was less frequent in group 2 (55% vs. 81%; P = 0.01).

Conclusion: Deployment of AEDs in public places by mandatory regulations increased utilization for OHCA and may improve outcomes.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Cognitive Dysfunction / epidemiology
  • Cohort Studies
  • Coronary Care Units
  • Defibrillators / statistics & numerical data
  • Defibrillators / trends*
  • Electric Countershock / statistics & numerical data
  • Electric Countershock / trends*
  • Emergency Medical Services
  • Female
  • Hospital Mortality
  • Humans
  • Israel
  • Male
  • Middle Aged
  • Mortality
  • Myocardial Infarction
  • Out-of-Hospital Cardiac Arrest / therapy*
  • Public Policy*
  • Retrospective Studies
  • Tachycardia, Ventricular / therapy*
  • Ventricular Fibrillation / therapy*