title: Incidence and outcome of out-of-hospital cardiac arrest with public-access defibrillation. A descriptive epidemiological study in a large urban community.
abstract: BACKGROUND
  Detailed characteristics of those who experience an out-of-hospital cardiac arrest (OHCA) with public-access defibrillation (PAD) are unknown.
  
  
  RESULTS
  A prospective, population-based observational study involving consecutive OHCA patients with emergency responder resuscitation attempts was conducted from July 1, 2004 through December 31, 2008 in Osaka City. We extracted data for OHCA patients shocked by a public-access automated external defibrillator (AED) and evaluated the patients' and rescuers' characteristics. The main outcome measure was neurologically favorable 1-month survival. During the study period, 10,375 OHCA patients were registered and of 908 patients suffering ventricular fibrillation arrest, 53 (6%) received public-access AED shocks by lay-rescuers, with the proportion increasing from 0% in 2004 to 11% in 2008 (P for trend<0.001). Railway stations (34%) were the places where PAD shocks were most frequently delivered, followed by nursing homes (11%), medical facilities (9%), and fitness facilities (7%). In 57% of cases, the subject received public-access AED shocks delivered by non-medical persons, including employees of railway companies (13%), school teachers (6%), employees of fitness facilities (6%), and security guards (6%). The proportion of neurologically favorable 1-month survival tended to increase from 0% in 2005 to 58% in 2008 (P for trend=0.081).
  
  
  CONCLUSIONS
  Railway stations are the most common places where shocks by public-access AEDs were delivered in large urban communities of Japan, and among lay-rescuers railway station workers use AEDs more frequently.
authors.affiliation: Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Mie
authors.initials: M
authors.lastname: Sasaki
authors.forename: Taku
authors.initials: T
authors.lastname: Iwami
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nomoto
authors.forename: Chika
authors.initials: C
authors.lastname: Nishiyama
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Sakai
authors.forename: Kayo
authors.initials: K
authors.lastname: Tanigawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kajino
authors.forename: Taro
authors.initials: T
authors.lastname: Irisawa
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishiuchi
authors.forename: Sumito
authors.initials: S
authors.lastname: Hayashida
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiraide
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawamura
mesh_terms: D000328:Adult; D000368:Aged; D047548:Defibrillators; D004554:Electric Countershock; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012151:Resuscitation / Q000295:instrumentation / Q000379:methods; D014505:Urban Population