Title : Impact of geographical location on out-of-hospital-cardiac arrest in urban and rural populations
Abstract:
Aim/Background: According to the World Health Organization cardiac arrest remains one of the world’s leading causes of mortality (2024) with markedly worse outcomes for those who experience out-of-hospital cardiac arrest (OHCA). The degree of urbanization can potentially increase outcomes in the chain of survival due to the proximity to cardiac arrest centres (CAC) or tertiary care facilities. This study aims to evaluate the outcomes between urban and rural patient populations around the globe who experience OHCA and provide recommendations for improving the chain of survival.
Methods: A review of three databases spanning January 1, 2014, until October 1, 2024, was conducted to collect literature investigating the incidence, management, and overall survival rates of out-hospital-cardiac arrests in urban and rural populations. 11 articles were identified and included in the literature review. There was no differentiation between survival to hospital admission, discharge, or at 30-days. All survival rates were included as eligible factors to examine OHCA and survivability in urban and rural populations.
Results: All literature reviewed concluded that there is a worse outcome in patients experiencing OHCA in rural populations when compared to those in urban populations. There is a likely correlation between prolonged response, scene, and transport times in rural municipalities with poor outcomes.
Conclusions: There is more research needed to establish confounding factors that are both modifiable and non-modifiable from region to region. Global definitions are not well developed to make data easily generalizable for several factors including the definition of rural and urban populations.
