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Background: Seacoasts are generally considered dangerous, and the situation of patients being transported from the coast to hospitals for emergency care has not been thoroughly examined. To clarify the acute health risks associated with the seacoast, we investigated the survival status of patients who arrived at the hospital following transportation from the seacoast by ambulance, compared with patients from other locations, and analyzed related factors. Methods: This study was designed as a retrospective observational study using a nationwide ambulance transportation database in Japan. All patients transported by ground ambulance to hospitals in Japan between January 1, 2020 and December 31, 2023 were enrolled in this study. Patients transported from the seacoast were compared with the patients from other locations concerning the cardiac arrest rate as a survival state. The variables of sex, age, response time (the period from the emergency call to the contact of the ambulance crew with the patient), season, day of the week, and cause (whether drowning or not) were also compared between the two groups. To adjust for the influence of these variables, we conducted propensity score matching between the two groups and compared the cardiac arrest rates in matched pairs. Results: Of the enrolled patients, 14,142 were from seacoast areas, and 21,586,384 were from other locations. Among seacoast patients, 8.7% experienced cardiac arrest upon hospital arrival, whereas 1.5% of patients from other locations experienced cardiac arrest (P<0.001). According to the multivariate logistic regression analysis, patients from the seacoast were more likely to be male [odds ratio (OR): 2.96, 95% confidence interval (CI): 2.84–3.08], younger (OR: 0.98; 95% CI: 0.98–0.98), have a longer response time (OR: 1.01; 95% CI: 1.01–1.01), and to be transported in summer (OR: 1.94; 95% CI: 1.88–2.01) or on weekends (OR: 1.78; 95% CI: 1.72–1.84). They were also much more likely to have drowning as the primary cause (OR: 122.60; 95% CI: 116.63–128.87). Even after adjusting for these factors using propensity score matching, the cardiac arrest rate remained higher in patients from the seacoast (8.5% vs. 3.0%, P<0.001). Conclusions: Even if the characteristic factors of patients from the seacoast, including longer response time and a high percentage of drowning, were adjusted by propensity matching, the rate of cardiac arrest remained higher in these patients. Thus, other injuries or illnesses may also contribute to a higher percentage of cardiac arrests in these patients.