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We describe the use of stroke alerts and ambulance services in different hospitals and patient groups and their relationship with reperfusion therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This nationwide study included 49,907 patients admitted with acute stroke who were registered in The Swedish Stroke Register (Riksstroke) in 2011\u20132012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportions of patients admitted as stroke alerts out of all acute stroke admissions varied from 12.2% to 45.7% in university hospitals (<jats:italic>n<\/jats:italic>\u00a0=\u00a09), 0.5% to 38.7% in specialized nonuniversity hospitals (<jats:italic>n<\/jats:italic>\u00a0=\u00a022), and 4.2% to 40.3% in community hospitals (<jats:italic>n<\/jats:italic>\u00a0=\u00a041). Younger age, atrial fibrillation (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>), living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were factors associated with a higher probability of stroke alerts. Living alone, primary school education, non\u2010European origin, previous stroke, diabetes, smoking, and dependency in activities of daily living (<jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>) were associated with a lower probability of stroke alert. The proportion of patients arriving at the hospital by ambulance varied from 60.3% to 94.5%. Older age, living alone, primary school education, being born in a European country, previous stroke, <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>, dependency in <jats:styled-content style=\"fixed-case\">ADL<\/jats:styled-content>, living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were associated with ambulance services. Hospital stroke alert frequencies correlated strongly with reperfusion rates (<jats:italic>r\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.75).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Acute stroke alerts have a significant potential to improve stroke reperfusion rates. Prehospital stroke management varies conspicuously between hospitals and patient groups, and the elderly and patients living alone have a markedly reduced likelihood of stroke alerts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.654","type":"journal-article","created":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T04:13:28Z","timestamp":1489637608000},"source":"Crossref","is-referenced-by-count":18,"title":["Acute stroke alert activation, emergency service use, and reperfusion therapy in Sweden"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3298-1555","authenticated-orcid":false,"given":"Marie","family":"Eriksson","sequence":"first","affiliation":[{"name":"Department of Statistics USBE, Ume\u00e5 University  Ume\u00e5 Sweden"},{"name":"Department of Public Health and Clinical Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva\u2010Lotta","family":"Glader","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Norrving","sequence":"additional","affiliation":[{"name":"Section of Neurology Department of Clinical Sciences Lund University  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitta","family":"Stegmayr","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kjell","family":"Asplund","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007212"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000259"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12149"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2015.04.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000355500"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000131083"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70100-5"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.621342"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3203"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-9-35"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.112.965210"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.002345x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2011.06.018"},{"key":"e_1_2_8_15_1","unstructured":"Medical Products Agency. 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