40 RESEARCH HIGHLIGHTS By Lars W. Andersen, Professor, Aarhus University Hospital, Denmark Use of Automated External Defibrillators in Private Homes Bystander interventions, including cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs), are increasingly common and recognized as critical components of the chain of survival. The use of AEDs has primarily been studied in public locations, where cardiac arrests are more visible and AED access is more common. A previous study using data from the Cardiac Arrest Registry to Enhance Survival (CARES) found that application of an AED is associated with improved outcomes in patients with out-of-hospital cardiac arrest presenting with a shockable rhythm (i.e., ventricular fibrillation or pulseless ventricular tachycardia) in a public location. A subsequent cost- effectiveness analysis demonstrated that AEDs are cost-effective in many public settings with a relatively high incidence of cardiac arrest. In contrast, there has been less focus on cardiac arrests occurring in private homes, which account for approximately 70–80% of all out-of-hospital cardiac arrests. Patients experiencing cardiac arrest in the home setting generally have worse outcomes, are less likely to present with a shockable rhythm, are less likely to receive bystander CPR, and often experience longer emergency medical services (EMS) response times compared with patients in public locations. Additionally, the incidence of cardiac arrest within any individual home is relatively low, making targeted AED placement challenging. Although the purchase of AEDs for private homes is increasingly discussed in the media and considered by some individuals, AEDs remain relatively expensive, and their effectiveness and cost- effectiveness in the home setting remain uncertain. This study consisted of two complementary analyses. In the first, we used data from 582,536 patients in the CARES registry to evaluate whether AED use was associated with improved outcomes for patients experiencing cardiac arrest in a private home. In the second, we used these results alongside existing literature to assess whether the purchase of AEDs for private homes could be considered cost-effective.
View this content as a flipbook by clicking here.