Summary
Public Access Defibrillation and prognosis of out-of-hospital cardiac arrest with shockable rhythm: observational study in a sparsely populated area
Manjot Singh Kaur1,3, Pablo Loma-Osorio1, Jaime Aboal Viñas1, Youcef Azeli2, Ester Ruiz de Morales Casademont4, Ramón Brugada Terradellas1,3
Affiliation of the authors
1Servicio de Cardiología, Hospital Universitari Dr. Josep Trueta, Girona, Spain. 2Área de Investigación y Desarrollo del Sistema d’Emergències Mèdiques (SEM). 3Centro de Genética Cardiovascular, Instituto de investigación biomédica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain. 4Organismo Autónomo de Salud Pública, Diputación de Girona (Dipsalut), Girona, Spain.
DOI
Quote
Singh Kaur M, Loma-Osorio P, Aboal Viñas J, Azeli Y, Ruiz de Morales Casademont E, Brugada Terradellas R. Public Access Defibrillation and prognosis of out-of-hospital cardiac arrest with shockable rhythm: observational study in a sparsely populated area. Rev Esp Urg Emerg. 2026;5:181-6
Summary
OBJECTIVE. To compare neurological status at hospital discharge, in-hospital mortality, and follow-up mortality between two groups of survivors of out-of-hospital cardiac arrest (OHCA) with shockable rhythm according to whether they were defibrillated by the Emergency Medical Services (EMS) or through a public access defibrillation (PAD) program implemented in a sparsely populated area.
MATERIAL AND METHODS. We conducted a prospective registry from the start of the PAD program including survivors of OHCA with an initial shockable rhythm who achieved return of spontaneous circulation and were admitted to a tertiary center. The population was divided into two groups of survivors: those initially defibrillated through public access defibrillation and those defibrillated by the EMS. Neurological status at hospital discharge, in-hospital mortality, and follow-up mortality were evaluated. Neurological status was assessed using the Cerebral Performance Category (CPC) scale.
RESULTS. During the study period, between 2012 and 2022, 457 OHCA survivors were admitted to our center; 152 had an initial shockable rhythm, 88 were defibrillated by EMS and 64 through the PAD program. Regarding neurological status at discharge, 73 % of patients were in CPC 1–2 in the PAD group vs 52 % in the EMS group. During hospitalization, 22.2 % died in the PAD group and 39.8 % in the EMS group (P = .036). During follow-up, the mortality rate was 32.1 % vs 65.3 %, respectively (P < .001).
CONCLUSIONS. In our low population-density area, survivors of OHCA with a shockable rhythm who were initially treated with PAD showed better neurological status at discharge and lower mortality during follow-up.