Risk factors associated with mortality during ems care: a case-control study (in Vinnytsia region)

Background: Emergency medical services (EMS) in Ukraine are currently under increased scrutiny for the quality of care that they provide. The Government initiated a set of policies to reform the EMS system. This study aimed to evaluate the EMS system to provide evidence-based recommendations for its improvement. Methods: A matched case-control study was used to determine risk factors associated with death during prehospital care. Vinnytsia oblast EMS dispatch center data was used to identify 898 patients that died during EMS care (cases), from January 17th, 2017 to June 19th, 2019. Each case was paired with a control patient (matched on age and chief complaint). A binary logistic regression was used to determine the association of risk factors with prehospital mortality. Results: The study found that ambulance response time (adjusted odds ratio 2.417; 95% confidence intervals 1.667 - 3.505; p = <0.001) and place of incident (adjusted odds ratio 2.658; 95% confidence intervals 1.661 - 4.254; p = <0.001) are associated with increased risk of mortality. Implications: The study discussed possible explanations of increased mortality and proposed strategies aimed at its reduction. However, further research is needed to investigate other factors that can potentially influence the mortality of patients in emergency conditions.
Emergency Medical Services, prehospital mortality, case-control, response time, master thesis