구급대원 현장 도착 시 명백한 사망징후를 보인 환자 발생에 영향을 미치는 요인에 대한 다수준 분석

초록

The aging society and increasing prevalence of single-person households have led to delayed emergency reporting, resulting in an increased incidence of dead-on-ambulance-arrival (DOAA) cases. This study aimed to analyze the status of DOAA patients in the Busan region and identify the factors influencing their occurrence, providing foundational data for establishing an emergency medical system that reflects local characteristics. Multiple and multilevel logistic regression analyses were performed on 5,671 out-of-hospital patients with cardiac arrest in Busan. Among the study population, 1,532 patients (27.0%) were classified as DOAA, corresponding to an incidence of 45.5 per 100,000 population, with Jung-gu District exhibiting the highest rate. Multilevel analysis demonstrated that the DOAA risk was higher among individuals aged <60 years (odds ratio [OR] = 3.334), during weekday incidents (OR = 1.206), and in areas with greater ambulance deployment (OR = 1.372). Conversely, a lower risk was observed among males (OR = 0.875), incidents occurring in public places (OR = 0.487), and calls made outside rush hour (OR = 0.865). This study demonstrated regional disparities in DOAA incidence attributable to both individual- and area-level factors. These findings underscore the need to establish community-specific early detection systems and strategically reallocate ambulance resources.

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