Ong Marcus Eng Hock, Tan Eng Hoe, Yan Xiuyuan, Anushia P, Lim Swee Han, Leong Benjamin Sieu-Hon, Ong Victor Yeok Kein, Tiah Ling, Yap Susan, Overton Jerry, Anantharaman V
Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore.
Resuscitation. 2008 Mar;76(3):388-96. doi: 10.1016/j.resuscitation.2007.09.006. Epub 2007 Oct 31.
Public access defibrillation (PAD) has shown potential to increase cardiac arrest survival rates.
To describe the geographic epidemiology of prehospital cardiac arrest in Singapore using geographic information systems (GIS) technology and assess the potential for deployment of a PAD program.
We conducted an observational prospective study looking at the geographic location of pre-hospital cardiac arrests in Singapore. Included were all patients with out-of-hospital cardiac arrest (OHCA) presented to emergency departments. Patient characteristics, cardiac arrest circumstances, emergency medical service (EMS) response and outcomes were recorded according to the Utstein style. Location of cardiac arrests was spot-mapped using GIS.
From 1 October 2001 to 14 October 2004, 2428 patients were enrolled into the study. Mean age for arrests was 60.6 years with 68.0% male. 67.8% of arrests occurred in residences, with 54.5% bystander witnessed and another 10.5% EMS witnessed. Mean EMS response time was 9.6 min with 21.7% receiving prehospital defibrillation. Cardiac arrest occurrence was highest in the suburban town centers in the Eastern and Southern part of the country. We also identified communities with the highest arrest rates. About twice as many arrests occurred during the day (07:00-18:59 h) compared to night (19:00-06:59 h). The categories with the highest frequencies of occurrence included residential areas, in vehicles, healthcare facilities, along roads, shopping areas and offices/industrial areas.
We found a definite geographical distribution pattern of cardiac arrest. This study demonstrates the utility of GIS with a national cardiac arrest database and has implications for implementing a PAD program, targeted CPR training, AED placement and ambulance deployment.
公众可获取除颤（PAD）已显示出提高心脏骤停存活率的潜力。
利用地理信息系统（GIS）技术描述新加坡院外心脏骤停的地理流行病学，并评估实施PAD项目的潜力。
我们开展了一项观察性前瞻性研究，观察新加坡院外心脏骤停的地理位置。纳入所有送至急诊科的院外心脏骤停（OHCA）患者。根据Utstein模式记录患者特征、心脏骤停情况、紧急医疗服务（EMS）响应及结果。使用GIS对心脏骤停位置进行现场绘图。
2001年10月1日至2004年10月14日，2428例患者纳入研究。心脏骤停患者的平均年龄为60.6岁，男性占68.0%。67.8%的心脏骤停发生在住宅，54.5%有旁观者目击，另有10.5%有EMS目击。EMS平均响应时间为9.6分钟，21.7%的患者接受了院外除颤。该国东部和南部的郊区镇中心心脏骤停发生率最高。我们还确定了心脏骤停率最高的社区。白天（07:00 - 18:59）发生的心脏骤停数量约为夜间（19:00 - 06:59）的两倍。发生频率最高的类别包括住宅区、车内、医疗保健设施、道路沿线、购物区和办公室/工业区。
我们发现了心脏骤停明确的地理分布模式。本研究证明了GIS与国家心脏骤停数据库结合的实用性，对实施PAD项目、有针对性的心肺复苏培训、自动体外除颤器（AED）放置及救护车部署具有启示意义。
