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Analyzing Prehospital Delays in Endovascular Treatment for Acute Stroke.

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Title: Analyzing Prehospital Delays in Endovascular Treatment for Acute Stroke.
Authors: Wang, Yalan (AUTHOR), Guo, Yapeng (AUTHOR), Wu, Kangfei (AUTHOR), Sun, Yi (AUTHOR), Wang, Hao (AUTHOR), Ni, Chuyuan (AUTHOR), Huang, Xianjun (AUTHOR), Cumming, Paul (AUTHOR)
Source: Acta Neurologica Scandinavica. 8/23/2025, Vol. 2025, p1-9. 9p.
Subjects: Ischemic stroke, Treatment delay (Medicine), Assistance in emergencies, Stroke, Neurologic examination, Endovascular surgery
Abstract: Objective: Delayed emergency responses in patients with large vessel occlusion stroke (LVOS) are associated with reduced access to timely reperfusion therapy and worse clinical outcomes. The present study was aimed at identifying modifiable factors contributing to delays before hospital arrival in LVOS patients undergoing endovascular treatment (EVT). Methods: In this retrospective analysis of prospectively collected data, consecutive acute LVOS patients undergoing EVT at two comprehensive stroke centers between December 2020 and December 2021 were enrolled. Neurologists administered a standardized questionnaire to patients or their caregivers within 24 h after the procedure. Emergency response delay was defined as onset to groin (OTG) time, measured from symptom onset or last known normal to groin puncture, exceeding 6 h. Baseline characteristics, process times, and clinical data were collected for all enrolled patients, and factors influencing the emergency process and outcomes were analyzed. Results: Of the 366 patients initially considered, 14 with in‐hospital stroke were excluded, leaving 352 patients for analysis. The median age was 70 years (63, 76), and 135 patients (38.4%) experienced treatment delays. The median National Institutes of Health Stroke Scale (NIHSS) score was 14 (11, 18), and the median Alberta Stroke Program Early CT Score (ASPECTS) was 9 (7.85, 10). Multivariate analysis identified the main modifiable factors associated with reduced emergency response delay as early calling of emergency services (odds ratio [OR] = 0.41, 95% confidence interval [CI]: 0.22–0.76), initial consultation with a neurologist (OR = 0.35, 95% CI: 0.20–0.62), and stroke awareness (OR = 0.51, 95% CI: 0.29–0.89). Among elderly patients and those whose stroke onset occurred during sleep, early contact with emergency services (120) significantly reduced prehospital delays (OR = 0.48, 95% CI: 0.21–0.94 and OR = 0.30, 95% CI: 0.10–0.86). Conclusion: Emergency physician involvement, stroke awareness, and early calling of emergency services (120) are modifiable factors that can reduce delays in the emergency response process. For patients eligible for EVT, minimizing prehospital delays may require prioritizing both community education on stroke recognition and system‐level improvements to ensure rapid emergency activation and timely neurological assessment. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Analyzing Prehospital Delays in Endovascular Treatment for Acute Stroke.
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  Data: <searchLink fieldCode="AR" term="%22Wang%2C+Yalan%22">Wang, Yalan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Guo%2C+Yapeng%22">Guo, Yapeng</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wu%2C+Kangfei%22">Wu, Kangfei</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sun%2C+Yi%22">Sun, Yi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Hao%22">Wang, Hao</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ni%2C+Chuyuan%22">Ni, Chuyuan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Huang%2C+Xianjun%22">Huang, Xianjun</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cumming%2C+Paul%22">Cumming, Paul</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. 8/23/2025, Vol. 2025, p1-9. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Ischemic+stroke%22">Ischemic stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+delay+%28Medicine%29%22">Treatment delay (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Assistance+in+emergencies%22">Assistance in emergencies</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Neurologic+examination%22">Neurologic examination</searchLink><br /><searchLink fieldCode="DE" term="%22Endovascular+surgery%22">Endovascular surgery</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Delayed emergency responses in patients with large vessel occlusion stroke (LVOS) are associated with reduced access to timely reperfusion therapy and worse clinical outcomes. The present study was aimed at identifying modifiable factors contributing to delays before hospital arrival in LVOS patients undergoing endovascular treatment (EVT). Methods: In this retrospective analysis of prospectively collected data, consecutive acute LVOS patients undergoing EVT at two comprehensive stroke centers between December 2020 and December 2021 were enrolled. Neurologists administered a standardized questionnaire to patients or their caregivers within 24 h after the procedure. Emergency response delay was defined as onset to groin (OTG) time, measured from symptom onset or last known normal to groin puncture, exceeding 6 h. Baseline characteristics, process times, and clinical data were collected for all enrolled patients, and factors influencing the emergency process and outcomes were analyzed. Results: Of the 366 patients initially considered, 14 with in‐hospital stroke were excluded, leaving 352 patients for analysis. The median age was 70 years (63, 76), and 135 patients (38.4%) experienced treatment delays. The median National Institutes of Health Stroke Scale (NIHSS) score was 14 (11, 18), and the median Alberta Stroke Program Early CT Score (ASPECTS) was 9 (7.85, 10). Multivariate analysis identified the main modifiable factors associated with reduced emergency response delay as early calling of emergency services (odds ratio [OR] = 0.41, 95% confidence interval [CI]: 0.22–0.76), initial consultation with a neurologist (OR = 0.35, 95% CI: 0.20–0.62), and stroke awareness (OR = 0.51, 95% CI: 0.29–0.89). Among elderly patients and those whose stroke onset occurred during sleep, early contact with emergency services (120) significantly reduced prehospital delays (OR = 0.48, 95% CI: 0.21–0.94 and OR = 0.30, 95% CI: 0.10–0.86). Conclusion: Emergency physician involvement, stroke awareness, and early calling of emergency services (120) are modifiable factors that can reduce delays in the emergency response process. For patients eligible for EVT, minimizing prehospital delays may require prioritizing both community education on stroke recognition and system‐level improvements to ensure rapid emergency activation and timely neurological assessment. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1155/ane/9281707
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      – Code: eng
        Text: English
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        PageCount: 9
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    Subjects:
      – SubjectFull: Ischemic stroke
        Type: general
      – SubjectFull: Treatment delay (Medicine)
        Type: general
      – SubjectFull: Assistance in emergencies
        Type: general
      – SubjectFull: Stroke
        Type: general
      – SubjectFull: Neurologic examination
        Type: general
      – SubjectFull: Endovascular surgery
        Type: general
    Titles:
      – TitleFull: Analyzing Prehospital Delays in Endovascular Treatment for Acute Stroke.
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            NameFull: Wang, Yalan
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            NameFull: Guo, Yapeng
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              M: 08
              Text: 8/23/2025
              Type: published
              Y: 2025
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