Relationship between Pre-Hospital Delays and Patient Outcomes in Acute Stroke Management: A Systematic Review

Abstract

This study aimed to investigate the associations between pre-hospital delays and outcomes for patients in acute stroke management. A total of 554 pertinent publications were found after a comprehensive search across four databases. Full-text publications (288) were examined after duplicates were eliminated using Rayyan QCRI and relevance was checked; six studies finally satisfied the requirements for inclusion. A total of 8906 patients were included, more than half of them 4953 (55.6%) were males. Research showed that early hospital admission leads to better survival, less disability, and better function, mainly from the early delivery of treatment such as thrombolysis. Nevertheless, delays are common for a variety of reasons including symptom appreciation, systemic, and/or logistical bottlenecks in emergency services. Reducing these delays by improved public awareness, improved emergency response, and better communication both between hospitals and emergency medical services (EMSs) will significantly enhance the stroke outcome and the disability burden itself. Minimizing pre-hospital delays is crucial for improving outcomes in acute stroke management. Timely and uninterrupted treatment increases access to life-saving interventions, reducing mortality and post-stroke disability. Pre-hospital delay has demonstrable effects on the outcome of acute stroke management, as early intervention is essential for survival and recovery. Strategies such as public awareness campaigns, enhanced EMS systems, and systemic reforms are essential for mitigating delays and improving stroke care efficiency. Future research should focus on evaluating interventions to reduce these delays, addressing healthcare disparities, and considering regional variations to optimize outcomes and reduce the global burden of stroke.