TOPLINE:

Out-of-hospital cardiac arrests (OHCAs) in airports were more often witnessed, involved an increased use of interventions before emergency medical service (EMS) arrival, showed higher rates of shockable rhythms, and resulted in higher return of spontaneous circulation (ROSC) compared with OHCAs in other nonresidential settings, a nationwide study from the US revealed.

METHODOLOGY:

• Researchers conducted a cross-sectional study and analyzed data on adults with cardiac arrest before EMS arrival using the National Emergency Medical Services Information System database between 2022 and 2023.
• The study included 1194 OHCAs in airports (37.9% among individuals aged 18-60 years; 72.6% among men) and compared them with 312,306 OHCAs in nonairport, nonresidential settings (47.2% among individuals aged 18-60 years; 67.7% among men).
• Key outcomes included whether the cardiac arrest was witnessed, pre-EMS cardiopulmonary resuscitation (CPR), use of an automated external defibrillator (AED), first monitored cardiac rhythm, cardiac arrest etiology, and ROSC.

TAKEAWAY:

• OHCAs in airports were more likely to be witnessed (81.0% vs 43.3%; P < .001) and have nontraumatic etiologies (96.1% vs 89.5%; P < .001) than those in nonairport settings.
• Pre-EMS interventions were more frequent in airports than in nonairport settings, with higher rates of CPR (62.6% vs 47.8%; P < .001) and AED use (56.3% vs 32.0%; P < .001).
• Patients with OHCAs in airports had better outcomes than patients with OHCAs in nonairport settings, with more frequent shockable initial rhythms (28.6% vs 13.8%; P < .001) and higher ROSC rates (40.7% vs 23.8%; P < .001). 

IN PRACTICE:

"This study suggests that due to a variety of factors, airports are associated with improved OHCA response and survival outcomes compared with other nonresidential settings — other public venues should try to replicate these factors to improve their cardiac arrest preparedness," the authors wrote.

SOURCE:

The study was led by Aditya C. Shekhar, MBE, Icahn School of Medicine, Mount Sinai, New York City. It was published online on August 29, 2025, in JAMA Network Open.

LIMITATIONS:

The study lacked data on long-term outcomes and did not account for patient comorbidities. Reliance on EMS documentation may have led to misclassification of cardiac arrest locations, and subclassification of specific locations within the airport was not possible.

DISCLOSURES:

Funding information was not provided for the study. Some authors reported receiving grants, royalties, honoraria, or personal fees from other sources outside the submitted work. Details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.