A cross‑sectional analysis of out‑of‑hospital cardiac arrests in a metropolitan area to determine optimal automated external defibrillator placement

Abstract

OBJECTIVES: The aim of this study is to determine the most appropriate locations for the effective use of automated external defibrillators (AEDs) by examining the locations and frequency of out of hospital cardiac arrests (OHCAs) in a metropolitan city in Izmir.

METHODS: This research is a retrospective cross sectional study. The data of the study were obtained from the Emergency Health Automation System. Data belonging to OHCA cases intervened by emergency aid ambulances were analyzed. The data were recorded and mapped by matching the regions where deaths occurred with the address records. Geographic Information Systems technologies were used in mapping the data. Kernel density analysis was used to produce density maps of point cases. Data analyses were performed with IBM SPSS Statistics 25.0 Statistical Program, and binary logistic regression analysis was used to determine the factors affecting the frequency of arrest. The significance value was accepted as P < 0.10 for logistic regression analysis and P < 0.05 for other tests.

RESULTS: In the study, a total of 1790 OHCA cases were identified in public areas in the center of the metropolitan city between 2015 and 2020. Of the 1790 OHCAs, 34.5% were female and 65.5% were male. 49.4% of the deaths were seen in public areas and on streets and avenues where human movement is high. Approximately 34.5% of the deaths were seen in nursing homes. Only one cardiac arrest case was seen at the international airport in the city. The average arrival time of ambulances was found to be 7.3 min in the city center.

CONCLUSION: This study is the first AED location determination study conducted in Turkey based on OHCA cases. Each country and region should reveal its sociocultural differences and make its plans by taking population mobility into account. Instead of making decisions based solely on the number of deaths, population mobility should be the determining factor. Countries should evaluate their AED installation policies in this context.

How to cite this article: Tortumlu M, Payza U, Çolak HE. Across‑sectional analysis of out‑of‑hospital cardiac arrests in a metropolitan area to determine optimal automated external defibrillator placement. Turk J Emerg Med 2025;25:265-72.

The Ethics Committee of Izmir Katip Çelebi University, Atatürk Training and Research Hospital, Non‑Interventional Ethics Committee was obtained for the study on February 13, 2020, with the number 611, and the Provincial Health Directorate Chief Physician Approval 112 on April 22, 2020, with the number of 42056799‑619 and with decision number of 2020/19.

UP: Conceptualization, Investigation, Methodology, Supervision, Validation, Writing – review and editing, Project administration.
EHÇ: Visualization, Data curation, Formal analysis, Methodology.
MT: Conceptualization, Investigation, Data curation, Formal analysis, Methodology, Writing – original draft.

None Declared.

None.

I would like to thank Associate Professor Başak Bayram, who shared her knowledge and experience with us during the design stage of the study, and Izmir Metropolitan Municipality Geographical Information Systems Branch Directorate for providing the spatial data on the streets in the city center.