Sun Christopher L F, Brooks Steven C, Morrison Laurie J, Chan Timothy C Y
From Department of Mechanical and Industrial Engineering (C.L.F.S., T.C.Y.C.) and Division of Emergency Medicine, Department of Medicine (L.J.M.), University of Toronto, ON, Canada; Department of Emergency Medicine, Queen's University at Kingston, ON, Canada (S.C.B.); and Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada (S.C.B., L.J.M., T.C.Y.C.).
Circulation. 2017 Mar 21;135(12):1104-1119. doi: 10.1161/CIRCULATIONAHA.116.025349.
Efforts to guide automated external defibrillator placement for out-of-hospital cardiac arrest (OHCA) treatment have focused on identifying broadly defined location categories without considering hours of operation. Broad location categories may be composed of many businesses with varying accessibility. Identifying specific locations for automated external defibrillator deployment incorporating operating hours and time of OHCA occurrence may improve automated external defibrillator accessibility. We aim to identify specific businesses and municipal locations that maximize OHCA coverage on the basis of spatiotemporal assessment of OHCA risk in the immediate vicinity of franchise locations.
This study was a retrospective population-based cohort study using data from the Toronto Regional RescuNET Epistry cardiac arrest database. We identified all nontraumatic public OHCAs occurring in Toronto, ON, Canada, from January 2007 through December 2015. We identified 41 unique businesses and municipal location types with ≥20 locations in Toronto from the YellowPages, Canadian Franchise Association, and the City of Toronto Open Data Portal. We obtained their geographic coordinates and hours of operation from Web sites, by phone, or in person. We determined the number of OHCAs that occurred within 100 m of each location when it was open (spatiotemporal coverage) for Toronto overall and downtown. The businesses and municipal locations were then ranked by spatiotemporal OHCA coverage. To evaluate temporal stability of the rankings, we calculated intraclass correlation of the annual coverage values.
There were 2654 nontraumatic public OHCAs. Tim Hortons ranked first in Toronto, covering 286 OHCAs. Starbucks ranked first in downtown, covering 110 OHCAs. Coffee shops and bank machines from the 5 largest Canadian banks occupied 8 of the top 10 spots in both Toronto and downtown. The rankings exhibited high temporal stability with intraclass correlation values of 0.88 (95% confidence interval, 0.83-0.93) in Toronto and 0.79 (95% confidence interval, 0.71-0.86) in downtown.
We identified and ranked businesses and municipal locations by spatiotemporal OHCA risk in their immediate vicinity. This approach may help policy makers and funders to identify and prioritize potential partnerships for automated external defibrillator deployment in public-access defibrillator programs.
为指导院外心脏骤停（OHCA）治疗中自动体外除颤器的放置所做的努力，主要集中在确定宽泛定义的位置类别，而未考虑运营时间。宽泛的位置类别可能由许多可达性各异的企业组成。结合运营时间和OHCA发生时间来确定自动体外除颤器部署的具体位置，可能会提高自动体外除颤器的可及性。我们旨在根据特许经营场所附近OHCA风险的时空评估，确定能使OHCA覆盖范围最大化的特定企业和市政场所。
本研究是一项基于人群的回顾性队列研究，使用来自多伦多地区RescuNET Epistry心脏骤停数据库的数据。我们确定了2007年1月至2015年12月期间在加拿大多伦多发生的所有非创伤性公共OHCA事件。我们从黄页、加拿大特许经营协会和多伦多市开放数据门户中，确定了在多伦多有≥20个场所的41种独特企业和市政场所类型。我们通过网站、电话或实地获取了它们的地理坐标和运营时间。我们确定了多伦多市整体及市中心每个场所开放时（时空覆盖范围）在其100米范围内发生的OHCA事件数量。然后根据时空OHCA覆盖范围对企业和市政场所进行排名。为评估排名的时间稳定性，我们计算了年度覆盖值的组内相关性。
共有2654例非创伤性公共OHCA事件。蒂姆·霍顿斯在多伦多排名第一，覆盖286例OHCA事件。星巴克在市中心排名第一，覆盖110例OHCA事件。加拿大五大银行的咖啡店和自动取款机在多伦多和市中心的排名中占据了前10名中的8个位置。排名显示出较高的时间稳定性，多伦多的组内相关性值为0.88（95%置信区间，0.83 - 0.93），市中心为0.79（95%置信区间，0.71 - 0.86）。
我们根据其附近的时空OHCA风险对企业和市政场所进行了识别和排名。这种方法可能有助于政策制定者和资助者在公共可及除颤器项目中识别自动体外除颤器部署的潜在合作伙伴并确定其优先级。
