Increased Defibrillator Access Improves Survival Rate

Japanese study credits public defibrillators with higher survival rate, minimal neurologic damage
By Jeff Muise
HealthDay Reporter

WEDNESDAY, March 17 (HealthDay News) -- The increasing availability of public-access automated external defibrillators (AEDs) in Japan has brought faster help to people who suffer out-of-hospital cardiac arrest and has improved the rate of survival without neurologic impairment, according to a study in the March 18 New England Journal of Medicine.

Tetsuhisa Kitamura, M.D., of the Kyoto University Health Service in Japan, and colleagues used a nationwide registry of out-of-hospital cardiac arrests for 2005 through 2007 to assess the effect of the dissemination of AEDs in public places during the same time period. The primary outcome was one-month rate of survival with minimal neurologic impairment.

The researchers found that, of 12,631 patients whose arrest was cardiac in origin, and in whom ventricular fibrillation was used, 462 patients were resuscitated by laypersons with public-access AEDs. Among all patients who had such out-of-hospital cardiac arrests, 31.6 percent of those resuscitated using AEDs were alive with minimal neurologic impairment a month later, compared to the overall rate of 14.4 percent. During the study period, AEDs in inhabited areas increased from fewer than one per square km to four or more, while the mean time to receiving a shock decreased from 3.7 to 2.2 minutes and the annual number of patients who survived with minimal neurologic impairment increased from 2.4 per 10 million to 8.9 per 10 million.

"This study underscores the importance not only of shocks administered early after a cardiac arrest but also of bystander-initiated cardiopulmonary resuscitation (CPR), irrespective of the type of CPR. The time from a patient's collapse to the initiation of CPR was reduced because of the increase in bystander-initiated CPR, and both early shock and early initiation of CPR contributed to a better outcome," the authors write.

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