Abstract
<title>Abstract</title> <p>Background: Industrial cities present unique operational challenges for Emergency Medical Services (EMS) due to concentrated occupational hazards and heterogeneous population demands. However, detailed EMS demand data from large industrial regions in the Middle East remain limited. This study examined ambulance call characteristics, temporal trends, and determinants of call severity in Al Jubail Industrial City, Saudi Arabia. Methods: A retrospective observational study was conducted using EMS dispatch data from Royal Commission Hospital between January 2022 and December 2024. All ambulance dispatches were included. Descriptive analyses characterized demographic, geographic, and operational features. Poisson regression evaluated temporal trends in call volume. Ordinal logistic regression identified predictors of increasing call severity, and multivariable logistic regression examined predictors of trauma-related versus medical calls. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: A total of 13,519 ambulance calls were analyzed. Most calls originated from community areas (90.5%), while industrial zones accounted for 9.5%. Industrial-area calls were predominantly male (92.6%), adult (99.1%), emergency dispatches (91.4%), and trauma-related (50.4% vs 14.7% in community areas; p < 0.001). Administrative and transfer-related complaints comprised 29.7% of all calls, largely within community settings. Call volume declined modestly over the three-year period (IRR 0.93 per year; p < 0.001) with limited seasonal variation. Increasing call severity was independently associated with trauma, medical emergencies, cardiovascular/metabolic complaints, infant and older adult age groups, and calls originating outside Jubail city (OR 4.67). Industrial location, male sex, and pediatric age group independently predicted trauma-related calls. Conclusion: EMS demand in Al Jubail demonstrates a dual operational profile: high-volume community demand driven by non-urgent and administrative calls, and lower-volume but high-acuity trauma demand from industrial zones. Call severity is primarily determined by clinical and geographic factors rather than temporal variation. These findings support context-specific EMS planning and trauma-focused readiness in industrial environments.</p>