Identifying High-risk Geographic Areas for Cardiac Arrest Using Three Methods for Cluster Analysis Academic Emergency Medicine, 03/16/2012

Sasson C et al. – The five high–risk census tracts identified may be possible sites for high–yield targeted community–based interventions to improve cardiopulmonary resuscitation (CPR) training and cardiovascular disease education efforts and ultimately improve survival from out–of–hospital cardiac arrest (OHCA).

• This was a secondary analysis of two prospectively collected registries in the city of Columbus, Ohio.
• Consecutive adult (≥18years) OHCA patients, restricted to those of cardiac etiology and treated by emergency medical services (EMS) from April 1, 2004, to April 30, 2009, were studied.
• Three different spatial analysis methods (Global Empirical Bayes, Local Moran’s I, and SaTScan’s spatial scan statistic) were used to identify high-risk census tracts.

• A total of 4,553 arrests in 200 census tracts occurred during the study period, with 1,632 arrests included in the final sample after exclusions for no resuscitation attempt, noncardiac etiology, etc.
• The overall incidence for OHCA was 0.70 per 1,000 people for the 6-year study period (SD=±0.52).
• Bystander CPR occurred in 20.2% (n=329), with 10.0% (n=167) surviving to hospital discharge.
• Five high-risk census tracts were identified by all three analytic methods.