Table 1. Characteristics and data extraction of the included studies.
| No | Author and year of publication | Study location | Study Design | Goal & Objective | Quality Domains | Sample N |
|---|---|---|---|---|---|---|
| 1 | Abdelrahman, H., et al. (2014) [10] | Qatar | Cross-sectional, retrospective analysis of all trauma-related deaths between January 2010 and December 2012 | • to analyze the time-based trauma mortality |
• Time-centered Effectiveness • Equity |
333 clients |
| 2 | Al-Ghamdi, A. S. (2002). [11] | Saudi Arabia | Cross-sectional study. Data collected between October 1999 and January 2000 | • to analyze the EMS response times | • Time-centered | 874 emergency calls |
| 3 | Al-Shaqsi, S., et al. (2014). [12] | Oman | Cross-sectional, retrospective study of road traffic trauma clients admitted to the Sultan Qaboos University Hospital between January and December 2011 | • to assess the differences in the outcome of road traffic trauma clients between those transported by EMS and those privately transported. | • Effectiveness • Equity |
821 EMS clients and 273 non-EMS clients |
| 4 | Al-Thani, H., et al. (2014). [13] | Qatar | Cross-sectional, retrospective study on medical records of all trauma clients who required intubation between January 2010 and December 2011 | • to analyze the outcome of PHI versus ERI. | • Effectiveness | 482 clients over 2 groups based on location of intubation procedure (PHI: 239, ERI: 243) |
| 5 | Alanazi, A. F. (2012). [14] | Saudi Arabia | Cross-sectional questionnaire-based study was undertaken among paramedics in 2011 | • to investigate the barriers faced by EMS providers in the city of Riyadh | • Patient-centered | 140 paramedics |
| 6 | AlHabib, K. F., et al. (2014). [15] | Multiple Arabian Gulf States | Prospective multicenter, cross-sectional study (Gulf RACE-2 study) among clients with a diagnosis of STEMI or unstable angina and non-STEMI recruited between October 2008 and June 2009 at 65 hospitals. | • to determine the rate and predictors of EMS use and to compare the clinical presentation, management, and short- and long-term outcomes for clients with ACS who used EMS versus those who did not. | • Time-centered Effectiveness • Equity |
5,184 clients |
| 7 | AlHabib, K. F., et al. (2016). [16] | Multiple Arabian Gulf States | Cross-sectional, retrospective analysis of data of a prospective study (Gulf RACE-3study) among consecutive clients with acute STEMI that were treated in hospitals in SA, Oman, UAE, Kuwait, Qatar, and Bahrain from 1 January 2014 to 15 January. | • to assess temporal changes in clinical arrivals and EMS usage rates • to describe the EMS system • to compare clinical presentation, management, and outcomes in the ED and in the hospital between clients that used EMS and those that used other means of transport, and between hospitals that provide PCI versus those that do not. |
• Time-centered • Effectiveness • Equity |
2,928 clients |
| 8 | AlHabib, K. F., et al. (2019).[17] | Saudi Arabia | Prospective, multi-center, study included all consecutive hospital admissions of patients with AMI, Between May 2015 and January 2017 | • to evaluate the clinical characteristics, management, and outcomes of a representative sample of patients with acute myocardial infarction (AMI) in Saudi Arabia. | • Effectiveness • Equity. |
2233 clients |
| 9 | Alrazeeni, D. M., et al. (2016). [18] | Saudi Arabia | Cross-sectional, retrospective analysis of patient care reports of non-transported emergency calls documented by 10 EMS stations in Riyadh, SA, between March and May 2014 | • to determine the epidemiology of non- transported EMS calls • to identify factors that contribute to non-transport of clients • to recommend suggestions for reduction in number of non-transported calls |
• Time-centered • Patient-centered • Equity |
1,791 clients |
| 10 | Althubaity, E., et al. (2013). [19] | Saudi Arabia | Cross-sectional face-to-face interviews using a structured questionnaire at 17 EMS centers between October and December 2011 | • to assess the knowledge, experience, and the impact of seniority of Saudi EMS personnel in dealing with acute stroke clients | • Effectiveness | 120 paramedics |
| 11 | Batt, A. M., et al. (2016). [20] | United Arab Emirates | Prospective cohort study of all presenting cases of OHCA between February 2014 and March 2015 in the Northern Emirates service area. | • to report the characteristics of OHCA clients and their outcomes | • Time-centered • Effectiveness • Equity |
384 clients |
| 12 | Bin Salleeh, H. M., et al. (2015). [21] | Saudi Arabia | Prospective cohort study of all presenting adult cases of OHCA between July 2012 and September 2013 at KKUH, ED, Riyadh. | • to report the characteristics and outcomes of OHCA clients | • Effectiveness Equity |
96 clients |
| 13 | Callachan, E. L., et al. (2016). [22] | United Arab Emirates | Survey of 195 physicians present at the hospital ED and were involved in care of clients with suspected ACS in Abu Dhabi between June 2012 and December 2013. | • to describe the perceptions towards EMS among physicians caring for clients with STEMI for 1) The likelihood of advising an ACS patient to use EMS to go to the hospital, 2) Satisfaction with the current EMS level of care given to ACS clients, 3) Likelihood of using the EMS for themselves or their family if a cardiac emergency occurs, and 4) Opinions regarding the steps that they felt could be taken to further improve EMS and Out-of-Hospital ACS care. | • Patient-centered | 106 physicians |
| 14 | Callachan, E. L., et al. (2016). [23] | United Arab Emirates | Semi structured interviews during an 18-month, multicenter, prospective study of consecutive clients admitted with STEMI to four government hospitals in Abu Dhabi. | • to estimate utilization, knowledge, and perceptions of EMS among clients with STEMI | Time-centered Effectiveness Patient-centered |
587 clients |
| 15 | Callachan, E. L., et al. (2017). [24] | United Arab Emirates | Retrospective review of EMS and hospital data obtained through chart review supplemented with prospectively collected follow-up data over a period of 18 months, with follow-up interviews at 30 days, six months, and one year after initial discharge. | • to assess differences in demographics, medical history, treatment times, and follow-up status among clients with STEMI who were transported to the hospital by EMS or by private vehicle, or were transferred from other medical facilities. | • Time-centered • Effectiveness |
455 clients |
| 16 | Dhaffar, K. O., et al. (2005). [25] | Saudi Arabia | Cross-sectional evaluation of SRCA evaluation forms filled out by the doctor on duty in the ER from 06 November 2002 to 5 December in Makkah. | • to evaluate the clients and the general appearance of the team and their cooperation | • Effectiveness | 632 clients |
| 17 | El-Menyar, Ayman., et al (2018) [26] | Qatar | A retrospective observational analysis was conducted on all patients with TBI who were admitted directly to the Hamad Trauma Center (HTC), from January 1, 2010 to December 31, 2014. | • to report the predictors and temporal patterns of death in moderate-to-severe isolated and polytrauma brain injuries in relation to their admission to the only national level 1 trauma center and comparing survivor to non-survivor. | • Time-centered | 810 clients |
| 18 | Fares, S., et al. (2011). [27] | Multiple Arabian Gulf States | Prospective, multicenter, study of consecutive clients hospitalized with ACS in 65 centers in five AGS (Kuwait, Oman, UAE, Yemen, Qatar, and Bahrain). Clients were enrolled in a pilot phase that lasted for 1 month in May 2006, and a subsequent study phase from January 2007 to June 2007. | • to examine EMS use by clients with ACS | • Time-centered • Effectiveness • Equity |
7,859 clients |
| 19 | Hamam, A. F., et al. (2015). [28] | Saudi Arabia | Cross-sectional observational study through interviewing the general public in public venues during 01 July 2010–31 Dec 2010. The survey consisted of a two parts questionnaire. The first part was completed for all subjects. The later was completed only for those subjects that had previous experience with the SRCA service in Jeddah. | • to investigate the level of public awareness of the EMS system | • Time-centered • Patient-centered |
1,534 participants from the general public |
| 20 | Irfan, F. B., et al. (2016). [29] | Qatar | Cross-sectional, observational study with prospective enrollment of OHCA clients from 1st June 2012 to 31st May 2013. Data were collected from incident reporting and dispatch data, EMS Out-of-Hospital care records, and patient medical records from 4 EDs and 8 hospitals. Follow-up was through access of hospital medical records and was censored at the date of death or up to 3 years from enrollment. Data for the OHCA registry were collected on all OHCA clients resuscitated by EMS | • to describes the epidemiology, EMS, and outcomes of OHCA. | • Time-centered • Effectiveness • Equity |
447 clients |
| 21 | Irfan, F. B., et al. (2017). [30] | Qatar | Retrospective, cross sectional, observational study that analyzed data from the HTC, trauma registry and OHCA registry. Data were collected on OHCA after trauma of clients from 1 January 2010–31 December 2015. | • to measure the outcomes of OHCA after trauma who determined by EMS and having received Out-of-Hospital cardiopulmonary resuscitation. • to determine the predictors of survival. |
• Time-centered • Effectiveness • Equity |
410 clients with OHCA after trauma |
| 22 | Nadar, Sunil K., et al. (2018) [31] | Oman | This retrospective study that took place between January 2012 and December 2016 at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman. All adult clients who presented following an OHCA to the Emergency Department of SQUH during the study period were included. | • to describe the epidemiological patterns of patients presenting to a tertiary care centre in Oman following an OHCA event. In addition, to assess the survival rate and demographic and angiographic features of resuscitated OHCA patients. | • Effectiveness | 216 clients |
| 23 | Ong, Marcus Eng Hock., et al. (2015) [32] | Multiple Asian Countries | prospective, international, multi-center cohort study of OHCA in the Asia-Pacific. Twelve sites from the seven PAROS countries participated in the study. The 12 sites were UAE (Dubai) is part of them. Each site contributed 1–3 years of data during the study period. data from January 2009 to December 2012. |
• describe the characteristics of OHCA transported by EMS and outcomes across the network sites. | • Time-centered. • Effectiveness • Equity |
66395 clients, of which 405 from Dubai, UAE |
| 24 | Shehab, A., et al. (2014)[33] | Multiple Arabian Gulf States | Prospective multicenter, cross-sectional study (Gulf RACE-2 study) among clients with a diagnosis of STEMI who admitted for reperfusion therapy and received pPCI and recruited between October 2008 and June 2009 at 65 hospitals. | • to explore the quality of pPCI practice and its impact on morbidity and mortality. | • Time-centered • Effectiveness |
3432 clients |
| 25 | Tham, L. P., et al. (2018). [34] | Multiple Asian Countries | Retrospective, cross-sectional analysis of PAROS study data from January 2009 to December 2012. PAROS is a prospective, observational, multi-center cohort study in the participating PAROS sites (12 sites from seven countries). The 12 sites were UAE (Dubai) is part of them. Each site contributed 1–3 years of data during the study period. data from January 2009 to December 2012. | • to describe the characteristics and outcomes, and to find factors associated with survival after pediatric OHCA. | • Effectiveness • Equity |
974 clients, of which 17 from the UAE |
ACLS, Advanced Cardiac Life Supports; AMI, Acute Myocardial Infarction; CPR, Cardio Pulmonary Resuscitation; CVS, Cardiovascular System; DNT, Door to Needle Time, EMS, Emergency Medical Services; ED, Emergency Department; ER, Emergency Room; ERI, Emergency Room Intubation; HTC, Hamad Trauma Centre; IQR, Interquartile Range; IV, Intra Venous; KKUH, King Khalid University Hospital; MEDEVAC, Medical Evacuations; OHCA, Out-of-Hospital-Cardiac-Arrest; PAROS, Pan-Asian Resuscitation Outcomes; PCR, Patient Care Report; PHI, Pre-Hospital Intubation; ROSC, Resuming of Spontaneous Circulation; SA, Saudi Arabia; SRCA, Saudi Red Crescent Authority; STEMI, S-T Elevated Myocardial Infarction; t-PA, Tissue Plasminogen Activator; UAE, Unites Arab Emirates