ArticlePloS one2021
Pre-hospital causes for delayed arrival in acute ischemic stroke before and during the COVID-19 pandemic: A study at two stroke centers in Egypt.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Factors associated with prehospital and in-hospital delays in acute ischaemic stroke care in Indonesia: a systematic review.BMJ open · 2025Pooled it
- Prehospital delay and associated factors among stroke patients in Africa: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses.Globalization and health · 2022Pooled it
- Factors facilitating pre-hospital delays in stroke patients' presentation to hospital by their caretakers in Uganda and suggested interventions.BMC neurology · 2025Article
- Association between Acute Care Accessibility and in-Hospital Mortality among Patients with Acute Ischemic Stroke.JMA journal · 2025Article
- Article
- Help-seeking and access to care for stroke and heart attack during the COVID-19 pandemic: A qualitative study.Sociology of health & illness · 2025Article
- Delays in Cardiovascular Emergency Responses in Africa: Health System Failures or Cultural Challenges?Global health, science and practice · 2024Article
- Role of the Critical Care Resuscitation Unit in a Comprehensive Stroke Center: Operations for Mechanical Thrombectomy During the Pandemic.The western journal of emergency medicine · 2024Article
- Acute care pathway assessed through performance indicators during the COVID-19 pandemic in OECD countries (2020-2021): a scoping review.BMC emergency medicine · 2024Article
- Stroke services in MENA: What is there and what is needed.PloS one · 2023Observational
- Gender disparity versus equality in acute stroke: a Middle Eastern country hospital-based study.The Egyptian journal of neurology, psychiatry and neurosurgery · 2023Article
- In-Hospital Emergency Treatment Delay Among Chinese Patients with Acute Ischaemic Stroke: Relation to Hospital Arrivals and Implications for Triage Pathways.International journal of general medicine · 2023Article
- Outcome and characteristics of COVID-19 patients associated with stroke: a multicenter hospital-based study in Egypt.The Egyptian journal of neurology, psychiatry and neurosurgery · 2022Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the current study we investigated the causes of pre-hospital delay as this can compromise the patient's chance to receive thrombolytic therapy and thus impact stroke outcome.
methodsWe surveyed 254 patients regarding reasons for delayed and early arrival to hospital after acute ischemic stroke. The survey was performed over five months, spanning a period pre- and during COVID-19 (between December 7, 2019 and May 10, 2020).
resultsA total of 71.2% of patients arrived beyond four hours of onset of ischemic stroke. The commonest cause for delay pre-Covid-19 was receiving treatment in a non-stroke hospital, while that during COVID-19 was fear of infection and lock down issues. Not realizing the urgency of the condition and stroke during sleep were common in both periods. Early arrival because of the patient's previous experience with stroke accounted for approximately 25% of cases in both periods. The effect of media was more evident during COVID-19, accounting for 47.7% of cases.
conclusionPre-hospital delay secondary to misperception of the urgency of stroke and management in a non-stroke hospital reflect the lack of awareness among the public and medical staff. This concept is emphasized by early arrival secondary to previous experience with stroke and the pronounced effect of media in the time of COVID-19.
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