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Bystander defibrillation for out-of-hospital cardiac arrest in Ireland.
Barry, Tomás; Kasemiire, Alice; Quinn, Martin; Deasy, Conor; Bury, Gerard; Masterson, Siobhan; Segurado, Ricardo; Murphy, Andrew W.
Afiliación
  • Barry T; School of Medicine, University College Dublin, Ireland.
  • Kasemiire A; Duke-NUS Medical School, Singapore.
  • Quinn M; UCD Centre for Support and Training in Analysis and Research, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
  • Deasy C; Out-of-Hospital Cardiac Arrest Register, National Ambulance Service, Health Services Executive.
  • Bury G; School of Medicine, University College Cork, Cork, Ireland.
  • Masterson S; University College Dublin, Ireland.
  • Segurado R; Clinical Strategy and Evaluation, Health Services Executive, National Ambulance Service, Ireland.
  • Murphy AW; UCD Centre for Support and Training in Analysis and Research, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
Resusc Plus ; 19: 100712, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39113756
ABSTRACT

Aims:

To describe and explore predictors of bystander defibrillation in Ireland during the period 2012 to 2020. To examine the relationship between bystander defibrillation and health system developments.

Methods:

National level Out of Hospital Cardiac Arrest (OHCA) registry data were interrogated, focusing on patients who had defibrillation performed. Bystander defibrillation (as compared to EMS initiated defibrillation) was the key outcome of concern. Logistic regression models were built and refined by fitting predictors, performing stepwise variable selection and by adding pairwise interactions that improved fit.

Results:

The data included 5,751 cases of OHCA where defibrillation was performed. Increasing year over time (OR 1.17, 95% CI 1.13, 1.21) was associated with increased adjusted odds of bystander defibrillation. Non-cardiac aetiology was associated with reduced adjusted odds of bystander defibrillation (OR 0.30, 95% CI 0.21, 0.42), as were increasing age in years (OR 0.99, 95% CI 0.987, 0.996) and night-time occurrence of OHCA (OR 0.67, 95% CI 0.53, 0.83). Six further variables in the final model (sex, call response interval, incident location (home or other), who witnessed collapse (bystander or not witnessed), urban or rural location, and the COVID period) were involved in significant interactions. Bystander defibrillation was in general less likely in urban settings and at home locations. Whilst women were less likely to receive bystander defibrillation overall, in witnessed OHCAs, occurring outside the home, in urban areas and outside of the COVID-19 period women were more likely, to receive bystander defibrillation.

Conclusions:

Defibrillation by bystanders has increased incrementally over time in Ireland. Interventions to address sex and age-based disparities, alongside interventions to increase bystander defibrillation at night, in urban settings and at home locations are required.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Resusc Plus Año: 2024 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Resusc Plus Año: 2024 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Países Bajos