{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:41:30Z","timestamp":1790286090913,"version":"4.1.0"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuroepidemiology"],"abstract":"<jats:p>Background: Despite decades of educational efforts, patients with acute ischemic stroke (AIS) remain delayed in seeking medical care, which becomes the greatest obstacle to the successful management of the condition.\nObjective: To systematically explore the incidence and influencing factors of pre-hospital care-seeking delay in acute ischemic stroke patients.\nMethods: We systematically searched the PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature from database inception to September 30, 2023. Meta-analysis was conducted using the Stata 15.0 software package. The pooled incidence was calculated using a random-effects model. The quality of studies reporting incidence data was assessed using Joanna Briggs Institute's Critical Appraisal Checklist and Newcastle-Ottawa Scale. Subgroup analyses were performed according to study location, country income, recruitment date, and age. \nResults: Finally, 30 related articles were included, involving a total of 287,102 people. The estimated incidence of pre-hospital care-seeking delay was 68%,and there were differences in this incidence in different countries (P= 0.035). Meta-analysis results showed that the delay rate was highest in low-income countries (85%) and lowest in high-income countries (62%). Patients who live farther from hospitals, have a lower level of education, diabetes, hyperlipidemia, or a history of stroke are more likely to experience delays (all P &lt;0.05). Conversely, those who can recognize stroke symptom , perceive the severity of early symptom, understand thrombolysis treatment, atrial fibrillation, consciousness disturbance, visual disturbance, and symptom score at admission, Emergency Medical Services use, and immediate help-seeking have a lower risk of delay (all P &lt; 0.05).\nConclusions: Pre-hospital care-seeking delays are common among patients with AIS, especially in low-income countries. To reduce delays, it is crucial to increase public awareness of stroke symptoms, improve education levels, and optimize healthcare accessibility.<\/jats:p>","DOI":"10.1159\/000542765","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T12:01:02Z","timestamp":1734609662000},"page":"1-20","source":"Crossref","is-referenced-by-count":5,"title":["Incidence and associated factors of pre-hospital care-seeking delay in people with acute ischemic stroke: a systematic review and meta-analysis"],"prefix":"10.1159","author":[{"given":"Yanjie","family":"zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuezhen","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyan","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengze","family":"Zhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongfei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DongPo","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizheng","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiqing","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changxu","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2024,12,19]]},"container-title":["Neuroepidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/ned\/article-pdf\/doi\/10.1159\/000542765\/4317431\/000542765.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/ned\/article-pdf\/doi\/10.1159\/000542765\/4317431\/000542765.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T11:02:59Z","timestamp":1745406179000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000542765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/000542765","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.28050557","asserted-by":"subject"}]},"ISSN":["0251-5350","1423-0208"],"issn-type":[{"value":"0251-5350","type":"print"},{"value":"1423-0208","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,19]]}}}