ArticleBMC emergency medicine2026
Logistic regression and simulation modelling to evaluate survival effects of EMS response time in suspected cardiac arrest.
Article in BMC emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNumerous studies have demonstrated the negative impact of longer ambulance response time on the outcomes of patients with out-of-hospital cardiac arrest (OHCA). However, timely emergency intervention may also be crucial in cases involving other severe medical conditions. The objective of our study was to determine whether improving emergency medical services (EMS) response times increases the chances of survival for patients that EMS call-taker assesses as suspected cardiac arrest based on the description of the witness to the collapse.
methodsWe conducted a retrospective, nationwide study of all age groups based on EMS records from ambulance trips, collected and maintained by the EMS Command and Control Centre of the Slovak Republic, covering the period from April 2022 to March 2024. Patients were considered to have survived if they were alive at the conclusion of the EMS intervention—either upon transfer to hospital staff or after being left at home. Correlation analysis and logistic regression were used to assess the association between response time and patient survival. The regression model was then applied to estimate the potential impact of reduced ambulance response times.
resultsThe dataset included records of 13,712 individuals with presumed cardiac arrest. Regression analysis revealed that ambulance response time had a significant negative effect on survival. An odds ratio of 0.951 (95% CI [0.942; 0.960]) indicates that the chances of survival decrease by approximately 5% with each additional minute of prolonged response time. We proposed several strategic measures to improve the availability of emergency medical services and evaluated their impact using computer simulation. Simulation revealed that by optimizing vehicle fleet composition, dispatch protocols, and ambulance station locations it would be possible to reduce the average response time for high-priority patients by almost 3 min and the median response time by 2.6 min, potentially leading to an estimated increase of 125 survivors annually among those suspected of cardiac arrest.
conclusionsReducing ambulance response times can significantly improve pre-hospital survival rates among patients who suffer out-of-hospital cardiac arrest.
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