Lengen Guillaume, Hugli Olivier, De Ridder David, Guessous Idris, Ladoy Anaïs, Joost Stéphane, Carron Pierre-Nicolas
University of Lausanne, Faculty of Biology and Medicine, 21 Rue du Bugnon, 1005 Lausanne, Switzerland.
Emergency Department, Lausanne University Hospital and University of Lausanne, 46 Rue du Bugnon, 1011 Lausanne, Switzerland.
Resusc Plus. 2024 Jul 13;19:100713. doi: 10.1016/j.resplu.2024.100713. eCollection 2024 Sep.
Out-of-hospital cardiac arrest (OHCA) incidence and survival often vary within regions according to patient-related and contextual factors. This study aims to establish the overall spatial dependence of incidence, bystander cardiopulmonary resuscitation (BCPR) and 48-h survival of OHCA with their associated demographic and socioeconomic characteristics in a Swiss region.
We conducted a retrospective study using data of all OHCAs recorded between 2007 and 2019 in the canton of Vaud and, more specifically, in the Lausanne area. Provision of BCPR and 48-h survival were analysed using Getis-Ord Gi statistics and OHCA incidence by local Moran's I with empirical Bayes standardised rates. Demographic and socioeconomic characteristics were compared between incidence clusters generated by local Moran's I method.
Significant spatial variations of OHCA incidence, BCPR and 48-h mortality were observed. Although BCPR was statistically more likely in rural areas, 48-h survival was improved in a few main cities. At the cantonal level, postcode areas with a higher incidence of OHCAs were less densely inhabited with lower salary levels, more Swiss citizens, and an older population. At city level, small area variations were detected within urban neighbourhoods. The more affected hectares with more OHCAs were less inhabited, with a better median salary, more Swiss citizens, and off-centre.
Spatial variations associated with demographic and socioeconomic factors were observed for OHCA incidence and survival, with sparsely populated areas particularly at risk. These data suggest an unmet need for targeted prevention interventions and structural modifications of the existing prehospital system at the cantonal level.
院外心脏骤停（OHCA）的发病率和生存率在不同地区常因患者相关因素和环境因素而有所不同。本研究旨在确定瑞士某地区OHCA发病率、旁观者心肺复苏（BCPR）及48小时生存率与其相关人口统计学和社会经济特征之间的总体空间依赖性。
我们进行了一项回顾性研究，使用了2007年至2019年间在沃州，更具体地说是在洛桑地区记录的所有OHCA数据。采用Getis-Ord Gi统计分析BCPR的提供情况和48小时生存率，采用局部Moran's I和经验贝叶斯标准化率分析OHCA发病率。通过局部Moran's I方法生成的发病率聚类之间比较人口统计学和社会经济特征。
观察到OHCA发病率、BCPR和48小时死亡率存在显著的空间差异。尽管农村地区进行BCPR在统计学上更有可能，但少数主要城市的48小时生存率有所提高。在州一级，OHCA发病率较高的邮政编码地区人口居住密度较低，工资水平较低，瑞士公民较多，且人口老龄化。在城市层面，在城市社区内检测到小区域差异。OHCA较多的受灾公顷居住人口较少，工资中位数较高，瑞士公民较多，且偏离中心。
观察到OHCA发病率和生存率与人口统计学和社会经济因素相关的空间差异，人口稀少地区尤其危险。这些数据表明，在州一级，有针对性的预防干预措施和对现有院前系统进行结构调整的需求尚未得到满足。
