23 Impact of public access defibrillation on the long-term outcomes of cardiac arrest survivors

Background Little is known about the impact of public access defibrillation (PAD) on the long-term outcomes following out-of-hospital cardiac arrest (OHCA). We examine the impact of PAD on functional recovery and health-related quality-of-life in 12 month survivors of OHCA. Method Between 2010 and 2016, adult OHCA survivors with an initial shockable rhythm were invited to participate in structured telephone interviews at 12 months post-arrest using the Glasgow Outcome Scale–Extended (GOSE), the EuroQol-5D (EQ-5D), and 12-Item Short Form (SF-12) health survey. Adjusted logistic regression was used to assess the effect of PAD on good functional recovery (GOSE ≥7) at 12 months. Results Of the 1,221 12 month survivors, 1036 (85.6%) participated in telephone interviews of which 144 (13.9%) were first shocked by PAD. When compared to patients first shocked by EMS, a higher proportion of patients shocked by PAD reported living at home without care (84.7% vs. 76.3%, p=0.02) and returning to work (83.3% vs. 71.5%, p=0.02). Although SF-12 mental component summary did not differ between groups, fewer patients shocked by PAD reported physical disability according to the SF-12 (35.7% vs. 45.3%, p=0.04). Best imaginable health status (an EQ-5D score of 1) was also reported more frequently in patients shocked by PAD (52.5% vs. 41.9%, p=0.02). After adjustment, PAD increased the odds of good functional recovery by 77% (adjusted odds ratio [AOR] 1.77, 95% CI: 1.16, 2.71; p=0.008). Conclusion Cardiac arrest patients shocked by PAD experience better long-term outcomes and more often report living independently. Conflict of interest None to declare. Funding Dr. Nehme is supported by an early career fellowship (#1146809) from the National Health and Medical Research Council.