Geospatial Analysis of Out-of-Hospital Cardiac Arrest Incidents in Central Tokyo

Background In urban areas, abundant medical resources improve outcomes for patients with out-of-hospital cardiac arrest (OHCA). However, metropolitan environments present unique pre-hospital transportation challenges rarely observed in rural areas, such as complex transportation networks and high-rise buildings. Additionally, social factors, such as economic disparities within the same city, may influence prognostic outcomes. This study aimed to identify urban-specific factors influencing patient outcomes by analyzing prognostic differences among patients with OHCA transported to an emergency center in the heart of a major city. Methods In this retrospective observational study, data regarding patients transported to Tokyo Medical and Dental University Hospital between June 1, 2016, and May 30, 2022, were extracted from electronic records. Using Bayesian spatial modeling, the relationship between geographical factors and neurological outcomes was analyzed. The relationships between on-scene response time and transport time of emergency medical services were also examined. Results A correlation was observed between neurological outcomes and geographical factors, such as the distance from the OHCA scene to the emergency center. Population density, building floor level, and land prices were also associated with neurological outcomes. Conclusions The findings indicate that geographical factors in metropolitan areas may influence patient outcomes. Furthermore, they highlight the importance of large-scale, multicenter studies in establishing more appropriate healthcare facilities in urban regions.