{ "abstract": "Background Prehospital delay in acute ischaemic stroke (AIS) remains prevalent in China. We aimed to assess the status of the onset-to-door time (ODT) in AIS and analyse its influencing factors.Methods Data were collected from a prospective multicentre hospital-based registry (China National Cerebrovascular Disease Prevention and Control Project Management Special Database) of patients with AIS involving 21 hospitals across different economic and geographical regions in China in 2022. The Mann-Whitney U test or t-test was used for between-group comparisons. Factors influencing ODT ≤3 hours were analysed using a binary logistic regression model.Results Of the included 12 484 patients (attended middle school or below, 69.2%), females had a higher illiteracy rate (13.1%) than males (4.8%); 94.8% were living with others at illness onset; 22.5% of patients/family members were aware of the stroke emergency map (SEM, but only 7.3% were transported by SEM; 76.8% lived within 20 km of the first visited hospital. Significant differences occurred in modes of arrival at hospitals among cities of different sizes (χ²=74.882, p<0.001). Being in a medium-sized (OR 0.65, 95% CI 0.50 to 0.86); large (OR 0.61, 95% CI 0.47 to 0.79) or extralarge city (OR 0.60, 95% CI 0.46 to 0.78); experiencing cardiogenic embolism (OR 0.65, 95% CI 0.50 to 0.86) or stroke of undetermined aetiology (OR 0.69, 95% CI 0.52 to 0.92); stroke onset between 18:00 and 23:59 (OR 0.71, 95% CI 0.60 to 0.85); distance <20 km from onset location to the hospital (OR 0.47, 95% CI 0.41 to 0.54); being transported by SEM (OR 0.31, 95% CI 0.26 to 0.36) and having initial National Institutes of Health Stroke Scale scores of 5–15 (OR 0.63, 95% CI 0.57 to 0.71) or 16–42 (OR 0.32, 95% CI 0.27 to 0.39) were independent factors favouring ODT ≤3 hours. Conversely, being transferred between hospitals during transportation (OR 3.31, 95% CI 2.66 to 4.14); experiencing wake-up stroke (OR 2.00, 95% CI 1.67 to 2.38); symptom-onset including dizziness (OR 1.28, 95% CI 1.10 to 1.47) and prestroke modified Rankin scale (mRS) score of 2–3 (OR 1.58, 95% CI 1.30 to 1.92) or 4–5 (OR 1.48, 95% CI 1.02 to 2.15) tended to indicate ODT >3 hours.Conclusions Urban scale, stroke type, onset time, distance from initial location to the first hospital visit, transportation method, stroke symptoms, prestroke mRS score and stroke severity significantly influenced prehospital delay. Our findings can facilitate the development of targeted policies.", "authors": [ { "affiliations": [ "Department of Neurology, The People’s Hospital of Gaoming District of Foshan City, Foshan, Guangdong, China" ], "name": "Ying Su" }, { "affiliations": [ "National Clinical Research Center for Cardiovascular Diseases, Fuwai hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China" ], "name": "Wenwei Qi" }, { "affiliations": [ "School of Medicine, Shenzhen University, Shenzhen, Guangdong, China" ], "name": "Yanni Yu" }, { "affiliations": [ "School of Medicine, Shenzhen University, Shenzhen, Guangdong, China" ], "name": "Jiaqian Zhu" }, { "affiliations": [ "School of Health Management, China Medical University, Shenyang, China" ], "name": "Xin Shi" }, { "affiliations": [ "Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China" ], "name": "Xiaohong Wu" }, { "affiliations": [ "Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China" ], "name": "Feng Chi" }, { "affiliations": [ "School of Medicine, Shenzhen University, Shenzhen, Guangdong, China" ], "name": "Runyu Xia" }, { "affiliations": [ "Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China" ], "name": "Limin Qin" }, { "affiliations": [ "Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China", "Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, China" ], "name": "Liming Cao" }, { "affiliations": [ "Department of Neurology, Fushun Central Hospital, Fushun, Liaoning, China" ], "name": "Yan Yang" }, { "affiliations": [ "Department of neurology, the Second People's Hospital of Yibin, Yibin, Sichuan, China" ], "name": "Qin Liu" }, { "affiliations": [ "Department of Neurology, The third People’s Hospital of Hubei Province, Wuhan, Hubei, China" ], "name": "Xiaoxiang Peng" }, { "affiliations": [ "Department of neurology, Yichun People’s Hospital, Jiangxi, China" ], "name": "Guobing Huang" }, { "affiliations": [ "Department of neurology, Beihai People’s Hospital, Beihai, China" ], "name": "Jinyan Chen" }, { "affiliations": [ "Department of neurology, Yanan University Affiliated Hospital, Yan an, Shanxi, China" ], "name": "Yidong Xue" }, { "affiliations": [ "Department of neurology, The First hospital of Baiyin city, Baiyin, China" ], "name": "Wenbiao Guan" }, { "affiliations": [ "Department of neurology, Chaoyang Central Hospital, Chaoyang, China" ], "name": "Dan Gao" }, { "affiliations": [ "Department of neurology, The Third The People's Hospital of Bengbu, Bengbu, Anhui, China" ], "name": "Bin Ye" }, { "affiliations": [ "Department of Neurology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China" ], "name": "Lijie Ren" } ], "title": "Analysis of prehospital delay in acute ischaemic stroke and its influencing factors: a multicentre prospective case registry study in China", "uid": "d40066d4-1082-542e-b1b3-e71ae8536e70" }