Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas

Background Patients with out‐of‐hospital cardiac arrest (OHCA) in rural areas experience longer emergency response times and have lower survival rates compared with patients in urban areas. Volunteer responders might improve care and outcomes for patients with OHCA specifically in rural areas. There...

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Main Authors: Astrid Rolin Kragh, Mads Tofte Gregers, Linn Andelius, Anne Juul Grabmayr, Louise Kollander, Victor Elnegaard Kjærulf, Julie Samsøe Kjølbye, Annam Pervez Sheikh, Annette Kjær Ersbøll, Fredrik Folke, Carolina Malta Hansen
Format: Article
Language:English
Published: Wiley 2024-02-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.123.032629
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author Astrid Rolin Kragh
Mads Tofte Gregers
Linn Andelius
Anne Juul Grabmayr
Louise Kollander
Victor Elnegaard Kjærulf
Julie Samsøe Kjølbye
Annam Pervez Sheikh
Annette Kjær Ersbøll
Fredrik Folke
Carolina Malta Hansen
author_facet Astrid Rolin Kragh
Mads Tofte Gregers
Linn Andelius
Anne Juul Grabmayr
Louise Kollander
Victor Elnegaard Kjærulf
Julie Samsøe Kjølbye
Annam Pervez Sheikh
Annette Kjær Ersbøll
Fredrik Folke
Carolina Malta Hansen
author_sort Astrid Rolin Kragh
collection DOAJ
description Background Patients with out‐of‐hospital cardiac arrest (OHCA) in rural areas experience longer emergency response times and have lower survival rates compared with patients in urban areas. Volunteer responders might improve care and outcomes for patients with OHCA specifically in rural areas. Therefore, we investigated volunteer responder interventions based on the degree of urbanization. Methods and Results We included 1310 OHCAs from 3 different regions in Denmark where volunteer responders had arrived at the OHCA location. The location was classified as urban, suburban, or rural according to the Eurostat Degree of Urbanization Tool. A logistic regression model was used to examine associations between the degree of urbanization and volunteer responder arrival before emergency medical services, cardiopulmonary resuscitation, or defibrillation. We found the odds for volunteer responder arrival before emergency medical services more than doubled in rural areas (odds ratio [OR], 2.60 [95% CI, 1.91–3.53]) and suburban areas (OR, 2.05 [95% CI, 1.56–2.69]) compared with urban areas. In OHCA cases where volunteer responders arrived first, odds for bystander cardiopulmonary resuscitation was tripled in rural areas (OR, 3.83 [95% CI, 1.64–8.93]) and doubled in suburban areas (OR, 2.27 [95% CI, 1.17–4.41]) compared with urban areas. Bystander defibrillation was more common in suburban areas (OR, 1.53 [95% CI, 1.02–2.31]), where almost 1 out of 4 patients received bystander defibrillation, compared with urban areas. Conclusions Volunteer responders are significantly more likely to arrive before emergency medical services in rural and suburban areas than in urban areas. Patients with OHCA received more cardiopulmonary resuscitation in rural and suburban areas and more defibrillation in suburban areas than in urban areas.
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spelling doaj-art-12e4c4aa2ea84c15be63e344455356b62025-08-20T02:26:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-02-0113410.1161/JAHA.123.032629Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural AreasAstrid Rolin Kragh0Mads Tofte Gregers1Linn Andelius2Anne Juul Grabmayr3Louise Kollander4Victor Elnegaard Kjærulf5Julie Samsøe Kjølbye6Annam Pervez Sheikh7Annette Kjær Ersbøll8Fredrik Folke9Carolina Malta Hansen10Copenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkCopenhagen Emergency Medical Services, University of Copenhagen Ballerup DenmarkBackground Patients with out‐of‐hospital cardiac arrest (OHCA) in rural areas experience longer emergency response times and have lower survival rates compared with patients in urban areas. Volunteer responders might improve care and outcomes for patients with OHCA specifically in rural areas. Therefore, we investigated volunteer responder interventions based on the degree of urbanization. Methods and Results We included 1310 OHCAs from 3 different regions in Denmark where volunteer responders had arrived at the OHCA location. The location was classified as urban, suburban, or rural according to the Eurostat Degree of Urbanization Tool. A logistic regression model was used to examine associations between the degree of urbanization and volunteer responder arrival before emergency medical services, cardiopulmonary resuscitation, or defibrillation. We found the odds for volunteer responder arrival before emergency medical services more than doubled in rural areas (odds ratio [OR], 2.60 [95% CI, 1.91–3.53]) and suburban areas (OR, 2.05 [95% CI, 1.56–2.69]) compared with urban areas. In OHCA cases where volunteer responders arrived first, odds for bystander cardiopulmonary resuscitation was tripled in rural areas (OR, 3.83 [95% CI, 1.64–8.93]) and doubled in suburban areas (OR, 2.27 [95% CI, 1.17–4.41]) compared with urban areas. Bystander defibrillation was more common in suburban areas (OR, 1.53 [95% CI, 1.02–2.31]), where almost 1 out of 4 patients received bystander defibrillation, compared with urban areas. Conclusions Volunteer responders are significantly more likely to arrive before emergency medical services in rural and suburban areas than in urban areas. Patients with OHCA received more cardiopulmonary resuscitation in rural and suburban areas and more defibrillation in suburban areas than in urban areas.https://www.ahajournals.org/doi/10.1161/JAHA.123.032629emergency respondersout‐of‐hospital cardiac arrestvolunteers
spellingShingle Astrid Rolin Kragh
Mads Tofte Gregers
Linn Andelius
Anne Juul Grabmayr
Louise Kollander
Victor Elnegaard Kjærulf
Julie Samsøe Kjølbye
Annam Pervez Sheikh
Annette Kjær Ersbøll
Fredrik Folke
Carolina Malta Hansen
Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
emergency responders
out‐of‐hospital cardiac arrest
volunteers
title Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas
title_full Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas
title_fullStr Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas
title_full_unstemmed Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas
title_short Volunteer Responder Interventions in Out‐of‐Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas
title_sort volunteer responder interventions in out of hospital cardiac arrest in urban suburban and rural areas
topic emergency responders
out‐of‐hospital cardiac arrest
volunteers
url https://www.ahajournals.org/doi/10.1161/JAHA.123.032629
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