ArticleeNeurologicalSci2019
Stroke onset to needle delay: Where these golden hours are lost? An Egyptian center experience.
Article in eNeurologicalSci, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Prehospital delay and associated factors among stroke patients in Africa: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Factors associated with delayed hospital presentation following stroke in Senegal: a mixed methods study.International journal of emergency medicine · 2026Article
- Impact of Onset-to-Needle Time on the Risk of Early Neurological Deterioration in Patients with Acute Ischemic Stroke Receiving Intravenous Thrombolysis.Therapeutics and clinical risk management · 2025Article
- The Urban-Rural Divide in Neurocritical Care in Low-Income and Middle-Income Countries.Neurocritical care · 2024Article
- Delays in receiving Alteplase and related factors in patients with stroke referred to Shahid Beheshti Hospital in Kashan-Iran in 2020-2021.Journal of education and health promotion · 2024Article
- Initial Results of a Direct Aspiration First-Pass Technique to Treat Acute Ischemic Stroke Patients in Nepal.Asian journal of neurosurgery · 2023Article
- Bilateral lysis of aortic saddle thrombus with early tissue plasminogen activator (BLASTT): a prospective, randomized, placebo-controlled study in feline acute aortic thromboembolism.Journal of feline medicine and surgery · 2022Article
- Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania-A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2022Article
- Pre- and in-hospital delays in the use of thrombolytic therapy for patients with acute ischemic stroke in rural and urban Egypt.Frontiers in neurology · 2022Article
- Machine learning approach for hemorrhagic transformation prediction: Capturing predictors' interaction.Frontiers in neurology · 2022Article
- Stroke in Africa: profile, progress, prospects and priorities.Nature reviews. Neurology · 2021Review
- Factors Affecting Pre-Hospital and In-Hospital Delays in Treatment of Ischemic Stroke; a Prospective Cohort Study.Archives of academic emergency medicine · 2021Article
- Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of intravenous recombinant tissue plasminogen activator (IV r-tPA) in early acute ischemic stroke (AIS) management faces a lot of difficulties in developing countries due to lessened guideline development with consecutive pre- and intra-hospital delay.
objectivesThe objective was to identify the barriers facing proper utilization of IV r-tPA for AIS in Tanta University Hospitals.
methodsThe study was conducted on 4124 AIS patients eligible to use IV r-tPA divided to group-I consisting of 442 patients who arrived the hospital within <3.5 h from the stroke onset and group-II consisting of 3682 patients who arrived >3.5 h from the stroke onset. The former group was further subdivided to 238 patients who received IV r-tPA (group-Ia) and 204 patients who did not receive IV r-tPA (group-Ib) due to different obstacles.
resultsThe main causes of pre-hospital onset to arrival delay were stroke unawareness, long travel time, incorrect beliefs, non-available neurologists, stroke onset during sleep and multiple causes (18.2%, 20.5%, 12.7%, 9.1%, 16% and 23.5% of cases, respectively). Causes of non-administration of IV r-tPA in eligible patients includes prolonged door-to-needle time, financial restraints, minor strokes, unavailable beds and fear of complications (41.2%, 26%, 12.7%, 11.3% and 8.8%, respectively).
conclusionIncreasing the chance of utilizing IV r-tPA for AIS patients' needs regular updating of the stroke chain of survival system to get the highest benefits from the available resources.
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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.