Makino Yuto, Kiguchi Takeyuki, Nishioka Norihiro, Okada Yohei, Shimamoto Tomonari, Matsuyama Tasuku, Nishiyama Chika, Kiyohara Kosuke, Kitamura Tetsuhisa, Iwami Taku
Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan.
Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan; Critical Care and Trauma Centre, Osaka General Medical Centre, Osaka, Japan.
Resuscitation. 2025 Jun 21:110691. doi: 10.1016/j.resuscitation.2025.110691.
Prompt automated external defibrillator (AED) use and shock delivery are crucial for improving outcomes in patients with out-of-hospital cardiac arrest (OHCA). This study was aimed at elucidating the current patterns of AED use by lay rescuers in Japan and exploring the associated factors by lay rescuer type.
In this observational study, data from the All-Japan Utstein Registry, a nationwide population-based registry of OHCAs, were analyzed. Patients with OHCA due to nonexternal causes that were witnessed by citizens were included. The primary outcome was AED use, defined as AED pad application, by each bystander witness type. As an exploratory analysis, we performed a multivariable logistic regression analysis of factors that could be associated with AED use.
In total, 33,426 individuals with OHCAs witnessed by citizens were included. Of these individuals, 20,410 were male (61.1%) with a median (interquartile range [IQR]) age of 80 (70, 87) years. AEDs were used in 12.6% of all OHCAs witnessed by citizens; and in 1.1%, 22.5%, and 37.7% of OHCAs witnessed by family members, citizens in public, and others, respectively. Regarding the OHCAs witnessed by citizens in public, female sex, weekends, and nighttime were associated with decreased AED use. Regardless of the witness type, dispatcher instructions and delays in response time were associated with increased AED use.
We elucidated the current patterns of AED use in Japan by using a nationwide population-based OHCA registry. We found that patient characteristics and various situational and systemic factors can influence AED use by citizens.
及时使用自动体外除颤器（AED）并进行电击对于改善院外心脏骤停（OHCA）患者的预后至关重要。本研究旨在阐明日本非专业救援者使用AED的当前模式，并按非专业救援者类型探索相关因素。
在这项观察性研究中，分析了全日本Utstein登记处的数据，该登记处是一个基于全国人口的OHCA登记处。纳入由公民目击的非外部原因导致的OHCA患者。主要结局是每种旁观者目击类型的AED使用情况，定义为应用AED电极片。作为探索性分析，我们对可能与AED使用相关的因素进行了多变量逻辑回归分析。
总共纳入了33426名由公民目击发生OHCA的个体。其中，20410名是男性（61.1%），年龄中位数（四分位间距[IQR]）为80（70，87）岁。在公民目击的所有OHCA中，12.6%使用了AED；在家庭成员、公共场所公民和其他人员目击的OHCA中，使用比例分别为1.1%、22.5%和37.7%。关于公共场所公民目击的OHCA，女性、周末和夜间与AED使用减少相关。无论目击类型如何，调度员指示和响应时间延迟与AED使用增加相关。
我们通过使用基于全国人口的OHCA登记处阐明了日本AED使用的当前模式。我们发现患者特征以及各种情境和系统因素会影响公民对AED的使用。
