Timing of Public-Access Defibrillation for Patients With Out-of-Hospital Cardiac Arrest: A Nationwide Cohort…

Cohort studyJournal of the American Heart Association· Aug 2026

Timing of Public-Access Defibrillation for Patients With Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study Using Time-Dependent Propensity Score Sequential Matching Approach.

Haruka Shida, Yoshimitsu Shimomura, Atsushi Hirayama … Tetsuhisa Kitamura

Resuscitation & Cardiac ArrestCohort studyTreatmentQ1IF 5.3

Public-access defibrillation linked to more favorable neurological survival after cardiac arrest

Timing of Public-Access Defibrillation for Patients With Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study Using Time-Dependent Propensity Score Sequential Matching Approach.

Haruka Shida … Tetsuhisa Kitamura

Journal of the American Heart Association · Aug 2026

Background

Earlier defibrillation is a key factor in improving survival in patients with out-of-hospital cardiac arrest due to ventricular fibrillation.

Methods

With out-of-hospital cardiac arrest who received public-access defibrillation before emergency medical services arrival were sequentially matched with patients at risk of receiving public-access defibrillation on a minute-by-minute basis using time-dependent propensity scores to address resuscitation time bias.

n = 1664 matched pairs

Results

public defibrillation before EMS arrival raised the odds of favorable neurological survival

RR 1.46 (95% CI 1.34 to 1.59)

null 1

1.34

1.59

CI excludes the null - significant

More results

After sequential matching, 1664 matched pairs were identified.

The effect sizes by public-access defibrillation timing were 1.33 (95% CI, 1.19-1.48) for 0 to 4 minutes, 1.49 (95% CI, 1.30-1.70) for 5 to 9 minutes, 1.55 (95% CI, 1.12-2.14) for 10 to 14 minutes, 2.46 (95% CI, 0.83-7.30) for 15 to 19 minutes, and 1.19 (95% CI, 0.29-4.85) after 20 minutes.

“

Conclusion

In Japan, among patients with bystander-witnessed ventricular fibrillation in public locations, public-access defibrillation before emergency medical services arrival was significantly associated with favorable neurological outcome, showing a directionally consistent association with improved outcomes regardless of time to emergency medical services arrival.

Timing of Public-Access Defibrillation for Patients With Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study Using Time-Dependent Propensity Score Sequential Matching Approach.

Timing of Public-Access Defibrillation for Patients With Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study Using Time-Dependent Propensity Score Sequential Matching Approach.

Related papers