title: Presumed Regional Incidence Rate of Out-of-Hospital Cardiac Arrest in Korea.
abstract: The regional incidence rates of out-of-hospital cardiac arrest (OHCA) were traditionally calculated with the residential population as the denominator. The aim of this study was to estimate the true incidence rate of OHCA and to investigate characteristics of regions with overestimated and underestimated OHCA incidence rates. We used the national OHCA database from 2006 to 2010. The nighttime residential and daytime transient populations were investigated from the 2010 Census. The daytime population was calculated by adding the daytime influx of population to, and subtracting the daytime outflow from, the nighttime residential population. Conventional age-standardized incidence rates (CASRs) and daytime corrected age-standardized incidence rates (DASRs) for OHCA per 100,000 person-years were calculated in each county. A total of 97,291 OHCAs were eligible. The age-standardized incidence rates of OHCAs per 100,000 person-years were 34.6 (95% CI: 34.3-35.0) in the daytime and 24.8 (95% CI: 24.5-25.1) in the nighttime among males, and 14.9 (95% CI: 14.7-15.1) in the daytime, and 10.4 (95% CI: 10.2-10.6) in the nighttime among females. The difference between the CASR and DASR ranged from 35.4 to -11.6 in males and from 6.1 to -1.0 in females. Through the Bland-Altman plot analysis, we found the difference between the CASR and DASR increased as the average CASR and DASR increased as well as with the larger daytime transient population. The conventional incidence rate was overestimated in counties with many OHCA cases and in metropolitan cities with large daytime population influx and nighttime outflow, while it was underestimated in residential counties around metropolitan cities.
authors.affiliation: Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Ro
authors.affiliation: Department of Social & Preventive Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Seung-Sik
authors.initials: SS
authors.lastname: Hwang
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
authors.affiliation: Department of Epidemiology & Biostatistics, Texas A&M University, College Station, TX, USA.
authors.forename: Daikwon
authors.initials: D
authors.lastname: Han
authors.affiliation: Department of Social & Preventive Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Sungchan
authors.initials: S
authors.lastname: Kang
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Jun
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: Sung-il
authors.initials: SI
authors.lastname: Cho
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012621:Seasons; D015996:Survival Rate; D013997:Time Factors
keywords: Epidemiology; Incidence; Out-of-Hospital Cardiac Arrest