The outcome of road traffic injury (RTI) is determined by duration of prehospital time, patient’s demographics, and the type of injury and its mechanism. During the emergency medical service (EMS) prehospital time interval, on-scene time should be minimized for early treatment. This study aimed to examine the factors influencing on-scene EMS time among RTI patients. We evaluated 19,141 cases of traffic trauma recorded between April 2014 and March 2020 in the EMS database of the Nara Wide Area Fire Department and the prehospital database of the emergency Medical Alliance for Total Coordination of Healthcare (e-MATCH). To examine the association of the number of EMS phone calls until hospital acceptance, age ≥65 years, high-risk injury, vital signs, holiday, and nighttime (0:00–8:00) with on-scene time, a generalized linear mixed model with random effects for four study regions was conducted. EMS phone calls were the biggest factor, accounting for 5.69 minutes per call, and high-risk injury accounted for an additional 2.78 minutes. Holiday, nighttime, and age ≥65 years were also associated with increased on-scene time, but there were no significant vital sign variables for on-scene time, except for the level of consciousness. Regional differences were also noted based on random effects, with a maximum difference of 2 minutes among regions. The number of EMS phone calls until hospital acceptance was the most significant influencing factor in reducing on-scene time, and high-risk injury accounted for up to an additional 2.78 minutes. Considering these factors, including regional differences, can help improve the regional EMS policies and outcomes of RTI patients.

中文翻译：

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与 EMS 现场时间相关的因素及其在道路交通伤害中的区域差异：一项基于人群的观察研究

道路交通伤害 (RTI) 的结果取决于院前时间的持续时间、患者的人口统计数据以及伤害类型及其机制。在紧急医疗服务 (EMS) 院前时间间隔期间，应尽量缩短现场时间以进行早期治疗。本研究旨在检查影响 RTI 患者现场 EMS 时间的因素。我们评估了 2014 年 4 月至 2020 年 3 月期间在奈良广域消防局的 EMS 数据库和医疗综合协调紧急医疗联盟 (e-MATCH) 的院前数据库中记录的 19,141 例交通创伤病例。检查直到医院接受的 EMS 电话数量、年龄≥65 岁、高危伤害、生命体征、假期和夜间（0:00-8:00）与现场时间的关系，对四个研究区域进行了具有随机效应的广义线性混合模型。EMS 电话是最大的因素，每个电话占 5.69 分钟，高危伤害占额外的 2.78 分钟。假期、夜间和年龄≥65 岁也与现场时间增加有关，但现场时间没有显着的生命体征变量，除了意识水平。基于随机效应还注意到区域差异，区域之间的最大差异为 2 分钟。直到医院接受 EMS 电话的数量是减少现场时间的最重要影响因素，高危伤害最多占额外的 2.78 分钟。考虑到这些因素，包括地区差异，