A predictive model saves more lives


April 8, 2019

Among the collaboration between the Ticino Cuore Foundation, the Cardiocentroticino and the University of Zurich, an analysis was conducted on the heterogeneity of cardiac arrest cases that occurred outside the hospital (OHCAOut of Hospital Cardiac Arrest) and which proposes the creation of a predictive model useful for preventing and reducing OHCAs in Ticino.

Main goals

Previous studies have indicated the existence of a cluster of subjects who have suffered an out-of-hospital cardiac arrest, both at national and state level. But, to date, a cluster of subjects at the municipal level had not been created. For this reason, the objectives of the report are to:

  • determine and analyze whether the incidence of cardiac arrests outside the hospital is evenly distributed throughout the Ticino Canton area;
  • evaluate and estimate the areas of greatest risk of cardiac arrests that occurred outside the hospital and whether this depends on the demographic characteristics of the resident population;
  • create a predictive model to predict cardiac arrests outside the hospital at the municipal level;

To conduct this analysis, the study team collected data on all cardiac arrests that occurred OHCA between January 2005 and December 2017, and then recorded and geo-localized them in a prospective way. Subsequently, the demographic characteristics (gender and age distribution) were collected at the individual municipality level by the Federal Statistical Office. The count and incidence were calculated at the level of each municipality, taking into account the gender and age distribution. Finally, a “validation group” was generated to try to estimate the percentage of future cardiac arrests in the Ticino area.

What they did

Out of a total of 2129 cardiac arrests occurring outside a hospital, 117 are those registered in the municipalities of the Canton Ticino. Of these, 70% occurred at home where 68% of cases were male and with an average age of 71 years. The team also highlighted that there is a concentration of events in the southern part of Ticino, with a distribution of events between the Ticino valleys. Furthermore, the largest number of cases was found in the most populated urban areas, although there are some less populated municipalities, but with a greater presence of male people with an average age of over 80 years.

What could be done

The test performed on the validation group made it possible to validate the predictive model, to such a point that was possible to demonstrate how, taking into account the territorial distribution of gender and age, up to 90% of the variability of events can be predicted.
A revolutionary approach which, together with the continuous preventive measures proposed by the Ticino Cuore Foundation and the network of First Responders using Momentum, would help Ticino to be the first region to be able to prevent cardiac arrests outside the hospital.