Out-of-Hospital Cardiac Arrest (OHCA) is a significant source of mortality and morbidity with wide variation in reported incidence and outcomes globally. The Irish Out-of-Hospital Cardiac Arrest Register (OHCAR) has collected nationwide data on treated OHCA since 2012. This research will use 2012 and 2013 OHCAR data to investigate the determinants of OHCA incidence and outcome in Ireland.
This is an epidemiological cross-sectional study based on observational data using geographical analysis techniques. The first aim will be to ensure the comprehensiveness and validity of OHCAR data by identifying missing cases for the study period. The potential effect of missing data on OHCAR results will be investigated. Missing case identification methodologies, data definitions and results will be compared between Sweden and Ireland. The OHCAR database will also be used for the first time for hypothesis testing.
A geographical model of OHCA incidence and outcome will be created. Event location and patient address data will be geocoded and linked to case attribute data including age, gender, bystander CPR, witness status, initial rhythm and OHCA outcome. Surrogate data on socioeconomic status will be linked to geocoded information. Baselayer data including road networks, population density, ambulance station and hospital locations will be added to the model. Geospatial analysis will be carried out to identify associations between OHCA, demography and predictors of survival.
Finally, the model will be used to investigate how demographic changes (i.e. estimated population projections) and alterations to the predictors of survival are likely to influence OHCA incidence and outcomes. This will also include modelling changes to bystander CPR provision and measuring the effect on travel times of improved proximity of ambulance and hospital services.
OHCAR is a now fully established, nationwide database and this research aims to utilise it so that OHCAR can support the integrated planning required to improve OHCA outcomes.
