ReviewFrontiers in neurology2017
If Time Is Brain Where Is the Improvement in Prehospital Time after Stroke?
Review in Frontiers in neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- A comprehensive meta-analysis of exogenous estrogen, progesterone, and testosterone in animal models of ischemic and hemorrhagic stroke.Biology of sex differences · 2026Pooled it
- Translational Intracerebral Hemorrhage Research: Has Current Neuroprotection Research ARRIVEd at a Standard for Experimental Design and Reporting?Translational stroke research · 2020Pooled it
- The rate of early neurological deterioration occurring after thrombolytic therapy: A meta-analysis.Brain and behavior · 2019Pooled it
- Digital Health-Enabled Prehospital Notification for Acute Stroke Using the Brain Saver Mobile App in Emergency Medical Transport in South Korea: Pilot Quasi-Experimental Study.JMIR medical informatics · 2026Article
- Factors associated with prehospital delay in stroke: A multicentre study from eastern India.The Indian journal of medical research · 2026Article
- Clinical symptoms associated with prehospital delay in first-ever acute stroke.Biomolecules & biomedicine · 2026Observational
- Evaluating the Impact of a System-Wide Prehospital Teleconsultation on Rural Stroke Transportation Efficiency.Stroke (Hoboken, N.J.) · 2026Article
- A Community Based Gallup Survey on Knowledge and Awareness of Stroke, Its Risk Factors and Warning Signs and Symptoms Among the Adult Population Across the Seven Sister States of Northeast India.Annals of neurosciences · 2026Article
- Stroke Survivor and Caregiver Perspectives on Seeking Emergency Medical Care.Journal of patient experience · 2026Article
- Beyond the golden hour: prehospital delay and in-hospital stroke mortality in an elderly cohort reaching a national emergency-medicine center in Kazakhstan.Frontiers in neurology · 2026Article
- Knowledge, practice, and awareness of stroke warning signs and potential risk factors among future rehabilitation specialists in Saudi Arabia.Frontiers in medicine · 2026Article
- Analysis of prehospital delay in acute ischaemic stroke and its influencing factors: a multicentre prospective case registry study in China.Stroke and vascular neurology · 2025Article
- Artificial Intelligence in Stroke Care: A Narrative Review of Diagnostic, Predictive, and Workflow Applications.Cureus · 2025Review
- Temporal Trends in Public Stroke Awareness in Korea, 2009 to 2023.Journal of the American Heart Association · 2025Article
- Predictors of pre-hospital delay among stroke patients in Yekatit-12 hospital Addis Ababa, Ethiopia: unmatched case-control study.International journal of emergency medicine · 2025Article
- Evaluation of pre- and in-hospital workflows and time intervals with acute ischemic stroke patients.PloS one · 2025Article
- Stroke knowledge and attitudes influence early hospital arrival in acute ischemic stroke: a multicenter cross-sectional survey from Hubei Province, China.Frontiers in neurology · 2025Article
- Global Insights on Prehospital Stroke Care: A Comprehensive Review of Challenges and Solutions in Low- and Middle-Income Countries.Journal of clinical medicine · 2024Review
- Mapping the Ecological Terrain of Stroke Prehospital Delay: A Nationwide Registry Study.Stroke · 2024Article
- A Multi-Parametric Approach for Characterising Cerebral Haemodynamics in Acute Ischaemic and Haemorrhagic Stroke.Healthcare (Basel, Switzerland) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite the availability of thrombolytic and endovascular therapy for acute ischemic stroke, many patients are ineligible due to delayed hospital arrival. The identification of factors related to either early or delayed hospital arrival may reveal potential targets of intervention to reduce prehospital delay and improve access to time-critical thrombolysis and clot retrieval therapy. Here, we have reviewed studies reporting on factors associated with either early or delayed hospital arrival after stroke, together with an analysis of stroke onset to hospital arrival times. Much effort in the stroke treatment community has been devoted to reducing door-to-needle times with encouraging improvements. However, this review has revealed that the median onset-to-door times and the percentage of stroke patients arriving before the logistically critical 3 h have shown little improvement in the past two decades. Major factors affecting prehospital time were related to emergency medical pathways, stroke symptomatology, patient and bystander behavior, patient health characteristics, and stroke treatment awareness. Interventions addressing these factors may prove effective in reducing prehospital delay, allowing prompt diagnosis, which in turn may increase the rates and/or efficacy of acute treatments such as thrombolysis and clot retrieval therapy and thereby improve stroke outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.