Out-of-hospital cardiac arrest in the home: Can area characteristics identify at-risk communities in the Republic of Ireland?

Abstract

BackgroundInternationally, the majority of out-of-hospital cardiac arrests where resuscitation is attempted (OHCAs) occur in private residential locations i.e. at home. The prospect of survival for this patient group is universally dismal. Understanding of the area-level factors that affect the incidence of OHCA at home may help national health planners when implementing community resuscitation training and services.MethodsWe performed spatial smoothing using Bayesian conditional autoregression on case data from the Irish OHCA register. We further corrected for correlated findings using area level variables extracted and constructed for national census data.ResultsWe found that increasing deprivation was associated with increased case incidence. The methodology used also enabled us to identify specific areas with higher than expected case incidence.ConclusionsOur study demonstrates novel use of Bayesian conditional autoregression in quantifying area level risk of a health event with high mortality across an entire country with a diverse settlement pattern. It adds to the evidence that the likelihood of OHCA resuscitation events is associated with greater deprivation and suggests that area deprivation should be considered when planning resuscitation services. Finally, our study demonstrates the utility of Bayesian conditional autoregression as a methodological approach that could be applied in any country using registry data and area level census data.Electronic supplementary materialThe online version of this article (10.1186/s12942-018-0126-z) contains supplementary material, which is available to authorized users.

Out of hospital cardiac arrests in the Gulf Region: a scoping review

“…Adult OHCA victims in the GCC region were consistently young, predominantly male, and often had underlying co-morbidities. Most OHCA cases occurred at home (ranging from 54% to 85% of all OHCA cases), consistent with international findings (14). See Table 1, Fig 2 and Fig 3 for further characteristics, and Appendix III for full details.…”

“…https://doi.org/10.1101/19014118 doi: medRxiv preprint Adult OHCA victims in the GCC region were consistently younger, predominantly male, and more co-morbid than their counterparts in Western studies. Most OHCA cases occurred at home (ranging from 54% to 85% of all OHCA cases), consistent with international findings 14 . See Table 1, Fig 2 and Fig 3 We observed differences in the characteristics of OHCA among ethnic groups in the region (e.g.…”

Relationship between socioeconomic factors, distribution of public access defibrillators and incidence of out-of-hospital cardiac arrest

“…27,28 Our findings are not unique to New Zealand, with several other countries reporting the incidence of OHCA is increased in areas of deprivation and in the older (>65 year-old) population. 4,9,10,29,30 Our results are consistent with known cardiovascular disease mortality in New Zealand, which is highest amongst those on the lowest income, of Maori or Pacific descent, males, and those >65 years-old. 31 Few other studies have investigated the incidence of OHCA by ethnicity at a similar area unit level: reduced risk was observed with an increasing Chinese population in Singapore and an increased risk was observed in neighbourhoods with an increased black population in North Carolina.…”

Out-of-hospital cardiac arrest in countries of the Gulf Cooperation Council: a scoping review

“…Adult OHCA victims in the GCC region were consistently young, predominantly male, and often had underlying co-morbidities. Most OHCA cases occurred at home (ranging from 54% to 85% of all OHCA cases), consistent with international findings (14). See Table 1 , Figure 2 and Fig ure 3 for further characteristics, and Appendix III for full details.…”