The spatial distribution of out-of-hospital cardiac arrest and the chain of survival in Ireland: a multi-class urban-rural analysis
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Date
2016Author
Masterson, Siobhán
Cullinan, John
Teljeur, Conor
Vellinga, Akke
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Recommended Citation
Masterson, S., Cullinan, J., Teljeur, C. and Vellinga, A. (2016) ‘The Spatial Distribution of Out-of-Hospital Cardiac Arrest and the Chain of Survival in Ireland: A Multi-Class Urban-Rural Analysis’. Irish Geography, 49(2), 1-27, DOI: 10.2014/igj.v49i2.1232
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Abstract
Abstract: Cardiac arrest occurs when the heart suddenly ceases to pump
blood around the body. To optimise survival from out-of-hospital cardiac
arrest (OHCA), knowledge of the spatial distribution of OHCA and the
availability of resuscitation, or ‘Chain of Survival’, is required. Thus,
this study aims to describe OHCA incidence and Chain of Survival
availability in a manner that can help inform pre-hospital planning in
the Republic of Ireland. In view of Ireland’s heterogeneous settlement
pattern, we analyse the association between varying degrees of rurality,
OHCA incidence and the availability of the Chain of Survival. In addition
to population density, settlement size, proximity to urban centres and
land use is taken into account which results in six classes: city; town;
accessible village; remote village; accessible rural; remote rural. Results
show that, when adjusted for age and sex, the incidence of adult OHCA
decreases with increasing rurality. Furthermore, while distance to the
nearest ambulance station and call-response interval is greater with
increasing rurality, the lowest levels of bystander cardiopulmonary
resuscitation occur in the most urban class. To the best of our knowledge,
this is one of the very first whole-country geographic descriptions of
OHCA to be performed internationally. It is also the first OHCA study
to use a multi-class urban-rural classification that considers rurality as
more than a function of population density