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Out-of-hospital cardiac arrest: Does rurality decrease chances of survival?

Kristian Bundgaard Ringgren¹, Kristian Hay Kragholm¹, Filip Lyng Lindgren¹

¹Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.

Resuscitation Plus

|February 11, 2022

Summary

This summary is machine-generated.

Response times for out-of-hospital cardiac arrest (OHCA) are longer in rural areas, but survival rates are similar to urban settings. This study found no significant difference in 30-day survival for OHCA patients in rural versus densely populated areas.

Keywords:

AED, Automated External Defibrillator ALS, Advanced Life Support BLS, Basic Life Support EMS response time EMS, Emergency Medical Services GPS, Global Positioning System Geography HEMS, Helicopter Emergency Services IQR, Interquartile Range OHCA OHCA, Out of Hospital Cardiac Arrest Out-of-hospital cardiac arrest Population density Survival

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Area of Science:

Emergency medicine
Public health
Cardiology

Background:

Geographical factors are often overlooked in out-of-hospital cardiac arrest (OHCA) research.
A common assumption is that rural living diminishes the likelihood of timely emergency medical services (EMS) response.
This study examines OHCA outcomes across different administrative regions in Denmark.

Purpose of the Study:

To investigate the hypothesis that rural geographical settings negatively impact OHCA outcomes.
To compare EMS response times and survival rates between rural and urban areas.
To analyze these factors across distinct healthcare administrative regions.

Main Methods:

Retrospective cohort study of witnessed out-of-hospital cardiac arrests (OHCA).
Categorization of arrests by location (public/residential) and population density for residential arrests.
Analysis of incidence, EMS response times, and 30-day survival rates based on area type and administrative region.

Main Results:

Of 8,579 OHCAs, 71% were residential, with 53.2% in the most densely populated areas.
Median EMS response times were 6 minutes for public and densely populated residential arrests, and 10 minutes for sparsely populated areas.
30-day survival was 38.5% for public arrests, and showed no statistically significant difference between densely (14.8%) and sparsely (13.4%) populated residential areas.

Conclusions:

EMS response times in Denmark are longer in rural settings compared to urban areas.
Despite longer response times, rural OHCAs do not show a statistically significant decrease in 30-day survival compared to densely populated areas.
Geographical setting does not appear to be a significant predictor of survival for OHCA patients in Denmark.