{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:10:25Z","timestamp":1789661425460,"version":"4.0.1"},"reference-count":26,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"abstract":"<jats:p>Introduction: Large-vessel occlusion (LVO) stroke requires rapid endovascular thrombectomy (EVT). Prehospital LVO screening combined with smartphone-based real-time prenotification may accelerate in-hospital activation, but supporting evidence remains limited. We evaluated a regional prehospital triage system integrating the Field Assessment Stroke Triage for Emergency Destination (FAST-ED) scale with the JoinTriage application. Methods: We conducted a single-center observational study comparing patients transported with suspected stroke before (2020\u20132021) and after (2022\u20132024) system implementation. During the after period, emergency medical service personnel used JoinTriage to share FAST-ED scores and clinical data in real time. We compared clinical characteristics and workflow metrics, including door-to-puncture (DTP) time, across the 2 periods. Results: The cohort included 721 patients (before, n = 262; after, n = 459). The LVO rate was significantly higher in the after period (25.5% vs. 18.7%, p = 0.043), with a numerically higher but nonsignificant EVT rate (19.4% vs. 14.1%, p = 0.083). Among FAST-ED\/JoinTriage-triaged patients (193\/459, 42.0%), LVO and EVT rates were further enriched, reaching 35.8% and 24.4%, respectively. Among EVT-treated patients, median DTP decreased from 88 to 62 min (p &lt; 0.001), and DTP of &lt;60 min increased from 10.8% to 46.8%. Multivariate analysis identified the after period as an independent predictor of DTP of &lt;60 min (adjusted odds ratio, 4.76; p = 0.019). The trend toward prolonged DTP during off-hours observed in the before period (p = 0.054) was resolved in the after period. Conclusion: The smartphone-based FAST-ED triage system was associated with a higher concentration of suspected LVO patients at the receiving hospital, as well as streamlined in-hospital workflow and reduced off-hour treatment delays.<\/jats:p>","DOI":"10.1159\/000553221","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:00:47Z","timestamp":1786118447000},"page":"1-10","source":"Crossref","is-referenced-by-count":0,"title":["Smartphone-Based Prehospital Stroke Triage Optimizes Workflow and Bridges the Off-Hour Delays in Endovascular Thrombectomy"],"prefix":"10.1159","author":[{"given":"Yuki","family":"Yamamoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Shimada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhisa","family":"Kanematsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Kuroda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izumi","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Ishihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Korai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuishin","family":"Izumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.3886"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2021-018547"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213570"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.4404"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.043875"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1177\/17562864211054962"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1755536"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.016026"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013301"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.19.5.604"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.20.7.864"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.24.1.35"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(74)91639-0"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000227191.01792.e3"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(00)02237-6"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001972"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1177\/20552076221137252"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-015033"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105220"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2023.120802"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-013772"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30034-1"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019983"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011721"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-017863"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.066114"}],"container-title":["Cerebrovascular 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