Spatiotemporal Stability of Public Cardiac Arrests

Derya Demirtas, Steven C. Brooks, Laurie J. Morrison, Timothy C.Y. Chan

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Background: Public access automated external defibrillator (AED) deployment and community cardiopulmonary resuscitation (CPR) programs should target geographical areas with high risk of out-of-hospital cardiac arrest (OHCA). Although these long-term, location-based interventions implicitly assume that the geographical OHCA risk remains stable over time, there is a paucity of evidence to support this assumption.

Objective: To determine whether geographic OHCA risk is stable over time in a Canadian urban setting.

Methods: We identified all atraumatic public-location OHCAs in Toronto, Canada from Jan. 2006 – Dec. 2014 and allocated each of them to one of the 140 neighborhoods defined by the City of Toronto. We then calculated the intra-class correlation (ICC) to measure the relative variability of OHCA counts within and between neighbourhoods over time.

Results: We identified 2506 atraumatic public OHCAs. The figure shows that the average number of public OHCAs in Toronto was 278.4 (±41.4) per year. The highest-risk neighborhood had an average number of 12.9 OHCAs per year and remained the highest-risk neighborhood during six of the nine years. The four lowest-risk neighborhoods each had a rate of 0.1 OHCA per year. The ICC value was 0.67 [95% CI, 0.61 to 0.73], indicating that there was less year-to-year variation within the same neighborhood (i.e., more temporal stability) and more variation between neighborhoods.

Conclusion: The OHCA rate in Toronto is stable at the neighborhood level over time. High-risk neighborhoods tend to remain high-risk, which supports focusing public health resources in those areas to increase the efficiency of these scarce resources and improve long-term impact.
Original languageEnglish
Article numberA15003
JournalCirculation
Volume132
Issue numberSuppl. 3
Publication statusPublished - 2015
EventResuscitation Science Symposium 2015 - Orange County Convention Center, Orlando, United States
Duration: 7 Nov 20159 Nov 2015

Fingerprint

Heart Arrest
Out-of-Hospital Cardiac Arrest
Defibrillators
Health Resources
Cardiopulmonary Resuscitation
Canada
Public Health

Cite this

Demirtas, D., Brooks, S. C., Morrison, L. J., & Chan, T. C. Y. (2015). Spatiotemporal Stability of Public Cardiac Arrests. Circulation, 132(Suppl. 3), [A15003].
Demirtas, Derya ; Brooks, Steven C. ; Morrison, Laurie J. ; Chan, Timothy C.Y. / Spatiotemporal Stability of Public Cardiac Arrests. In: Circulation. 2015 ; Vol. 132, No. Suppl. 3.
@article{0fda01b827ab4547b3cf3a00468f57d3,
title = "Spatiotemporal Stability of Public Cardiac Arrests",
abstract = "Background: Public access automated external defibrillator (AED) deployment and community cardiopulmonary resuscitation (CPR) programs should target geographical areas with high risk of out-of-hospital cardiac arrest (OHCA). Although these long-term, location-based interventions implicitly assume that the geographical OHCA risk remains stable over time, there is a paucity of evidence to support this assumption.Objective: To determine whether geographic OHCA risk is stable over time in a Canadian urban setting.Methods: We identified all atraumatic public-location OHCAs in Toronto, Canada from Jan. 2006 – Dec. 2014 and allocated each of them to one of the 140 neighborhoods defined by the City of Toronto. We then calculated the intra-class correlation (ICC) to measure the relative variability of OHCA counts within and between neighbourhoods over time.Results: We identified 2506 atraumatic public OHCAs. The figure shows that the average number of public OHCAs in Toronto was 278.4 (±41.4) per year. The highest-risk neighborhood had an average number of 12.9 OHCAs per year and remained the highest-risk neighborhood during six of the nine years. The four lowest-risk neighborhoods each had a rate of 0.1 OHCA per year. The ICC value was 0.67 [95{\%} CI, 0.61 to 0.73], indicating that there was less year-to-year variation within the same neighborhood (i.e., more temporal stability) and more variation between neighborhoods.Conclusion: The OHCA rate in Toronto is stable at the neighborhood level over time. High-risk neighborhoods tend to remain high-risk, which supports focusing public health resources in those areas to increase the efficiency of these scarce resources and improve long-term impact.",
author = "Derya Demirtas and Brooks, {Steven C.} and Morrison, {Laurie J.} and Chan, {Timothy C.Y.}",
note = "Abstracts From the American Heart Association's 2015 Scientific Sessions and Resuscitation Science Symposium",
year = "2015",
language = "English",
volume = "132",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "Suppl. 3",

}

Demirtas, D, Brooks, SC, Morrison, LJ & Chan, TCY 2015, 'Spatiotemporal Stability of Public Cardiac Arrests' Circulation, vol. 132, no. Suppl. 3, A15003.

Spatiotemporal Stability of Public Cardiac Arrests. / Demirtas, Derya; Brooks, Steven C.; Morrison, Laurie J.; Chan, Timothy C.Y.

In: Circulation, Vol. 132, No. Suppl. 3, A15003, 2015.

Research output: Contribution to journalMeeting AbstractAcademic

TY - JOUR

T1 - Spatiotemporal Stability of Public Cardiac Arrests

AU - Demirtas, Derya

AU - Brooks, Steven C.

AU - Morrison, Laurie J.

AU - Chan, Timothy C.Y.

N1 - Abstracts From the American Heart Association's 2015 Scientific Sessions and Resuscitation Science Symposium

PY - 2015

Y1 - 2015

N2 - Background: Public access automated external defibrillator (AED) deployment and community cardiopulmonary resuscitation (CPR) programs should target geographical areas with high risk of out-of-hospital cardiac arrest (OHCA). Although these long-term, location-based interventions implicitly assume that the geographical OHCA risk remains stable over time, there is a paucity of evidence to support this assumption.Objective: To determine whether geographic OHCA risk is stable over time in a Canadian urban setting.Methods: We identified all atraumatic public-location OHCAs in Toronto, Canada from Jan. 2006 – Dec. 2014 and allocated each of them to one of the 140 neighborhoods defined by the City of Toronto. We then calculated the intra-class correlation (ICC) to measure the relative variability of OHCA counts within and between neighbourhoods over time.Results: We identified 2506 atraumatic public OHCAs. The figure shows that the average number of public OHCAs in Toronto was 278.4 (±41.4) per year. The highest-risk neighborhood had an average number of 12.9 OHCAs per year and remained the highest-risk neighborhood during six of the nine years. The four lowest-risk neighborhoods each had a rate of 0.1 OHCA per year. The ICC value was 0.67 [95% CI, 0.61 to 0.73], indicating that there was less year-to-year variation within the same neighborhood (i.e., more temporal stability) and more variation between neighborhoods.Conclusion: The OHCA rate in Toronto is stable at the neighborhood level over time. High-risk neighborhoods tend to remain high-risk, which supports focusing public health resources in those areas to increase the efficiency of these scarce resources and improve long-term impact.

AB - Background: Public access automated external defibrillator (AED) deployment and community cardiopulmonary resuscitation (CPR) programs should target geographical areas with high risk of out-of-hospital cardiac arrest (OHCA). Although these long-term, location-based interventions implicitly assume that the geographical OHCA risk remains stable over time, there is a paucity of evidence to support this assumption.Objective: To determine whether geographic OHCA risk is stable over time in a Canadian urban setting.Methods: We identified all atraumatic public-location OHCAs in Toronto, Canada from Jan. 2006 – Dec. 2014 and allocated each of them to one of the 140 neighborhoods defined by the City of Toronto. We then calculated the intra-class correlation (ICC) to measure the relative variability of OHCA counts within and between neighbourhoods over time.Results: We identified 2506 atraumatic public OHCAs. The figure shows that the average number of public OHCAs in Toronto was 278.4 (±41.4) per year. The highest-risk neighborhood had an average number of 12.9 OHCAs per year and remained the highest-risk neighborhood during six of the nine years. The four lowest-risk neighborhoods each had a rate of 0.1 OHCA per year. The ICC value was 0.67 [95% CI, 0.61 to 0.73], indicating that there was less year-to-year variation within the same neighborhood (i.e., more temporal stability) and more variation between neighborhoods.Conclusion: The OHCA rate in Toronto is stable at the neighborhood level over time. High-risk neighborhoods tend to remain high-risk, which supports focusing public health resources in those areas to increase the efficiency of these scarce resources and improve long-term impact.

M3 - Meeting Abstract

VL - 132

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - Suppl. 3

M1 - A15003

ER -

Demirtas D, Brooks SC, Morrison LJ, Chan TCY. Spatiotemporal Stability of Public Cardiac Arrests. Circulation. 2015;132(Suppl. 3). A15003.