Abstract 242: Association Of The Nearest Static AED With Treatment And Outcome Of OHCA In Forsyth County, North Carolina

Abstract

Introduction: Over the last two decades, publicly accessible AEDs have become available in communities across the US, allowing bystanders to rapidly intervene during OHCA. The impact of static AEDs on rates of bystander AED application and OHCA outcomes is poorly understood. Methods: We created a static AED registry for Forsyth County, NC (mixed rural-urban county with population ~ 380,000 ) primarily through phone-based surveys of businesses. These data were linked to the Cardiac Arrest Registry to Enhance Survival and geocoded to calculate proximity between OHCA and nearest static AED. The AHA recommends that publicly accessible AEDs be placed to achieve bystander retrieval within 100 meters (m) of OHCA. Multivariable logistic regression modeling examined the relationship between AED proximity and survival to hospital discharge. Results: Included were 2078 patients >18 years old with OHCA between 2013-2019 and 573 businesses with at least one AED. There were 219 (10.5%), 190 (9.1%), 1669 (80.3%) OHCAs with an AED within <100m, 100-200m, and >200m, respectively. OHCA incidence was highest where static AEDs were closest. Static AEDs within 100m of OHCA were primarily at residential facilities (41.1%), health care clinics (26.5%), churches (9.1%), and schools (6.8%). Among OHCAs with nearest AED >200m, AEDs were primarily owned by schools (32.2%), healthcare facilities (15%), industrial facilities (10.6%), and churches (10.4%). Bystander CPR was highest for OHCAs in closest proximity to an AED (<100m: 61.2%; 100-200m: 51.6%; >200m: 39.5%, p<0.001). Bystander AED application was highest where static AEDs were closest to OHCA (28.3%, 14.2%, and 3.8% at <100m, 100-200m, and >200m, respectively, p<0.001). Among patients who were defibrillated, bystander defibrillation was 18.1%, 20%, and 3.9% (p<0.001). There was no difference for survival to hospital discharge (<100m: 15.1%; 100-200m: 15.3%; >200m: 13.1%, p=0.54), even after adjustment (aOR 1.002, 95% CI 0.995-1.008 per 10m decrease). Conclusion: Only 10% of OHCAs in Forsyth County were within 100 meters of a static AED. Bystander CPR and AED application were highest where static AEDs were <100m from OHCA. Despite this, there was no association between AED proximity and survival to hospital discharge.