• Alexander Andrew Matthew Mills, Elisabeth Helen Anna Mills, Stig Nikolaj Fasmer Blomberg, ChristensenHelle CollatzHCCopenhagen Emergency Medical Services, Copenhagen and University of Copenhagen.Danish Clinical Quality Program (RKKP), Rigshospitalet., Amalie Lykkemark Møller, Gunnar Gislason, Lars Køber, Kristian Hay Kragholm, Freddy Lippert, Frederik Folke, Mikkel Porsborg Andersen, and Christian Torp-Pedersen.
• Aalborg University.
• Eur J Emerg Med. 2024 Feb 1; 31 (1): 596759-67.

Background And ImportanceEnsuring prompt ambulance responses is complicated and costly. It is a general conception that short response times save lives, but the actual knowledge is limited.ObjectiveTo examine the association between the response times of ambulances with lights and sirens and 30-day mortality.DesignA registry-based cohort study using data collected from 2014-2018.Settings And ParticipantsThis study included 182 895 individuals who, during 2014-2018, were dispatched 266 265 ambulances in the Capital Region of Denmark.Outcome Measures And AnalysisThe primary outcome was 30-day mortality. Subgroup analyses were performed on out-of-hospital cardiac arrests, ambulance response priority subtypes, and caller-reported symptoms of chest pain, dyspnoea, unconsciousness, and traffic accidents. The relation between variables and 30-day mortality was examined with logistic regression.ResultsUnadjusted, short response times were associated with higher 30-day mortality rates across unadjusted response time quartiles (0-6.39 min: 9%; 6.40-8.60 min: 7.5%, 8.61-11.80 min: 6.6%, >11.80 min: 5.5%). This inverse relationship was consistent across subgroups, including chest pain, dyspnoea, unconsciousness, and response priority subtypes. For traffic accidents, no significant results were found. In the case of out-of-hospital cardiac arrests, longer response times of up to 10 min correlated with increased 30-day mortality rates (0-6.39 min: 84.1%; 6.40-8.60 min: 86.7%, 8.61-11.8 min: 87.7%, >11.80 min: 85.5%). Multivariable-adjusted logistic regression analysis showed that age, sex, Charlson comorbidity score, and call-related symptoms were associated with 30-day mortality, but response time was not (OR: 1.00 (95% CI [0.99-1.00])).ConclusionLonger ambulance response times were not associated with increased mortality, except for out-of-hospital cardiac arrests.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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