Bitencourt Marcos Rogério, Bitencourt Mariá Romanio, Silva Lincoln Luís, Santos Amanda Gubert Alves Dos, Iora Pedro, Labbado José Anderson, Lemos Mauricio Medeiros, de Paulo Luiz Gustavo, Gabella Júlia Loverde, Lourenço Lopes Costa Juliana, Dolci Hideky Ikeda, Giacomin Vinicius, Pelloso Sandra Marisa, de Barros Carvalho Maria Dalva, de Andrade Luciano
Post Graduate Program in Health Sciences, State University of Maringá, Maringá 87020-900, Paraná, Brazil.
Department of Medicine, State University of Maringá, Maringá 87020-900, Paraná, Brazil.
Int J Environ Res Public Health. 2025 Jan 27;22(2):173. doi: 10.3390/ijerph22020173.
Out-of-hospital cardiac arrests (OHCAs) have high mortality rates, worsened by limited access to automated external defibrillators (AEDs). This study analyzed OHCA response times, identified areas with prolonged ambulance travel times, and proposed optimal AED locations in a medium-sized city in southern Brazil. Data from 278 non-traumatic OHCA cases (2019-2022) in patients over 18 years old, with ambulance response times under 20 min, were included. Spatial survival analysis assessed the probability of exceeding the recommended 5-min (300 s) ambulance response time. The maximal covering location problem identified 100 strategic AED sites within a 150-s reach for bystanders. AED and ambulance travel times were compared using the Wilcoxon test ( < 0.01). Defibrillation occurred in 89 cases (31.01%), and bystander CPR was performed in 149 cases (51.92%). Despite these efforts, 77% of patients died. The median ambulance response time was 11.63 min, exceeding 5 min in most cases, particularly at peak times like 11 a.m. AED placement in selected locations could cover 76% of OHCA occurrences, with a mean AED travel time of 320 s compared to 709 s for ambulances. Strategic AED placement could enhance early defibrillation and improve survival outcomes.
院外心脏骤停（OHCA）死亡率很高，而自动体外除颤器（AED）获取受限使情况更加恶化。本研究分析了OHCA的响应时间，确定了救护车行驶时间较长的区域，并在巴西南部一个中等规模城市中提出了AED的最佳放置地点。纳入了278例18岁以上非创伤性OHCA病例（2019 - 2022年）的数据，这些病例的救护车响应时间在20分钟以内。空间生存分析评估了超过建议的5分钟（300秒）救护车响应时间的概率。最大覆盖选址问题确定了100个对旁观者而言在150秒可达范围内的战略AED站点。使用Wilcoxon检验比较AED和救护车的行驶时间（<0.01）。89例（31.01%）发生了除颤，149例（51.92%）进行了旁观者心肺复苏。尽管如此，77%的患者死亡。救护车响应时间的中位数为11.63分钟，大多数情况下超过了5分钟，尤其是在上午11点这样的高峰时段。在选定地点放置AED可覆盖76%的OHCA事件，AED的平均行驶时间为320秒，而救护车为709秒。战略性AED放置可增强早期除颤并改善生存结果。
Zotero 插件
