Association between nationwide introduction of public-access defibrillation and sudden cardiac death in Japan: An interrupted time-series analysis

• Published in: International Journal of Cardiology Vol. 351; pp. 100 - 106
• Main Authors: Ishii, Taku, Nawa, Nobutoshi, Morio, Tomohiro, Fujiwara, Takeo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.03.2022; Elsevier BV
• Subjects: Adolescent; Adult; Aged; Automated external defibrillator; Child; Child, Preschool; Death, Sudden, Cardiac; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - prevention & control; Defibrillators; Electric Countershock; Female; Humans; Interrupted Time Series Analysis; Japan; Japan - epidemiology; Japanese Government Statistics database; Male; Middle Aged; Out-of-Hospital Cardiac Arrest; Public-access-defibrillation; Sudden cardiac death; Young Adult; Japan; AED; PAD; OHCA; ICD-10; Japanese Government Statistics database; SCD; Automated external defibrillator; Out-of-hospital cardiac arrest; Interrupted time-series analysis; ICD; Public-access-defibrillation; Sudden cardiac death
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2021.12.016

The effectiveness of public-use of automated external defibrillators in reducing the number of sudden cardiac death (SCD) cases at the national level is largely unknown. Our study aimed to evaluate whether the nationwide introduction of public-access-defibrillation (PAD) in 2004 affected the trend of annual sudden cardiac death (SCD) rates in Japan. The number of nationwide SCDs occurring in people aged five years and older was extracted from Japanese demographic statistics (1995–2015). Segmented regression analysis was performed on the interrupted time series data stratified by age and sex to evaluate changes in trends of rates of annual SCDs after the PAD introduction in Japan. After the PAD introduction in 2004, we observed a significant decrease in trends of annual SCD rates for those aged 5–19 years (the ratio of trends between pre and post PAD introduction (RT) = 0.886, 95%CI: 0.801 to 0.980), 20–34 years (RT = 0.932; 95%CI: 0.906, 0.958), 35–49 years (RT = 0.953; 95%CI: 0.929, 0.977) and 50–64 years (RT = 0.971; 95%CI: 0.971, 0.991). However, the decrease was not observed for those aged 65 years and older. In the age and sex stratified analysis, there was a significant decrease in RT among males aged 5–64 years, and among females 35–49 years. The nationwide trend of annual rate of SCDs between 5 and 64 years old significantly decreased after the introduction of PAD in 2004 in Japan. Further, the reduction was more evident in males. [Display omitted] •Interrupted time series analysis was conducted to evaluate the association between introduction of PAD and SCD.•Nationwide numbers of sudden cardiac deaths extracted from the official Japanese Statistical Database were analyzed.•Trend of the annual SCDs in Japan significantly decreased in a certain age group after 2004 when PAD has been legalized in Japan.•Age groups in which the annual SCDs decreased significantly were different between male and female.PAD, public-access defibrillation; SCD, sudden cardiac deaths.