الإصدار 2 - العدد 4 (2025-07-20)

The Association Between Emergency Medical Services Response Time, Survival Rates, and Community Impacts Among Adults with Out-of-Hospital Cardiac Arrest: A Systematic Review

Mohammed Ali Alnashwan

Mohammed Saleh Almutairi

Meshal Salaf Al-Otaibi

Saud Ammar H. Almutairy

Nasser Abdulmohsen Alwatban

Mnahi Hassan Mohammed Al-Kahtani

Fahad Salem Alfaifi

Naif Abdullah Al-Otaibi

Mubarak Ayesh Al Mutairi

Adel Hamad AlMutairi

الانتماء المؤسسي للباحث:

Emergency Medical Technician Riyadh Saudi Arabia

ملخص البحث:

Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening emergency requiring rapid intervention to improve patient survival. Emergency Medical Services (EMS) response time is an important indicator of prehospital care performance. However, variations in response intervals, patient characteristics, and healthcare systems may influence survival outcomes.

Objective: To systematically review the association between EMS response time and survival among adults experiencing OHCA, with particular consideration of implications for prehospital emergency care in Saudi Arabia.

Methods: A systematic review of studies published between January 2000 and December 2024 was conducted using PubMed, Scopus, Web of Science, Embase, and the Cochrane Library. Observational studies, cohort studies, and registry-based analyses examining EMS response time and survival outcomes were considered. A narrative synthesis was used because of methodological and clinical heterogeneity.

Results: Thirteen international studies were summarized, including 12 addressing the principal survival or neurological outcomes and one providing contextual evidence. Overall, shorter EMS response times were associated with improved survival to hospital discharge, 30-day survival, and favorable neurological outcomes. A North American study involving 41,012 adults reported reduced odds of survival to discharge (adjusted odds ratio [aOR] 0.92; 95% CI 0.91–0.93) and favorable neurological survival (aOR 0.88; 95% CI 0.86–0.89) for each additional response minute. Individual studies identified response-time thresholds ranging from 6.2 to 7.5 minutes, although these were not universally applicable. Two additional Saudi Arabian studies provided descriptive evidence regarding prehospital response performance.

Conclusion: Shorter EMS response times are generally associated with improved survival following adult OHCA. However, differences in study methodologies and patient characteristics limit causal interpretation and the identification of a universal response-time threshold. Improving ambulance response performance, early CPR, rapid defibrillation, and integrated outcome monitoring may strengthen prehospital emergency care, particularly in Saudi Arabia.