Location-resolved performance of public-access defibrillation in an urban EMS system: a population-based study in Yokohama, Japan.
Public access defibrillation shock linked to over 3-fold higher odds of favorable neurological outcome.
Location-resolved performance of public-access defibrillation in an urban EMS system: a population-based study in Yokohama, Japan.
Survival rates after out-of-hospital cardiac arrest (out-of-hospital cardiac arrest) in Japan have plateaued despite widespread automated external defibrillator (automated external defibrillator) deployment, suggesting a gap between availability and real-world effectiveness.
We aimed to examine the association between public access defibrillation (public access defibrillation) shock and neurological outcomes and evaluate location-specific patterns of public access defibrillation shock rates.
We retrospectively analysed data from the Yokohama City out-of-hospital cardiac arrest registry from 2021 to 2024.
public defibrillation before EMS arrival more than triples good neurological recovery odds
Among 15,345 patients, 8828 (57.5%) were male and 272 (1.8%) received a public access defibrillation shock.
Public access defibrillation shock rates varied markedly across arrest locations, ranging from 34.0% (18/53) in sports facilities and 28.0% (30/107) at railway stations to 0.06% (6/10,426) in private residences.
Public access defibrillation shock is independently associated with favourable neurological outcomes after out-of-hospital cardiac arrest.
However, its real-world effectiveness is shaped by urban structural contexts and relies on high-quality, comprehensive bystander interventions.
A location-resolved performance framework may serve as a practical tool for guiding targeted resuscitation strategies beyond uniform automated external defibrillator deployment.