{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:04:58Z","timestamp":1789769098750,"version":"4.0.1"},"reference-count":0,"publisher":"Association of Basic Medical Sciences of FBIH","issue":"11","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomol Biomed"],"abstract":"<jats:p>Early hospital arrival is essential for timely reperfusion therapy in acute stroke. This study aimed to identify clinical, symptom-related, and prehospital factors associated with delayed hospital arrival among patients with first-ever acute stroke, with particular focus on the 4.5-hour therapeutic window. This prospective single-center observational study was conducted at a comprehensive stroke center in Istanbul, T\u00fcrkiye, between December 2023 and October 2024. Among 362 patients screened for suspected acute cerebrovascular events, 205 adults with first-ever acute ischemic stroke, intracerebral hemorrhage, or transient ischemic attack managed through the acute stroke pathway were included. Data were collected using a structured clinical form and a questionnaire on barriers to accessing acute stroke treatment, administered through face-to-face interviews with patients\u2019 relatives. Prehospital delay was defined as the interval from last known well (LKW) to hospital arrival. Patients were analyzed according to arrival within 1 hour, 2 hours, 3 hours, and 4.5 hours, using appropriate comparative statistical tests.\u00a0The mean LKW-to-arrival time was 338.66 \u00b1 345.67 minutes, with a median (IQR) of 240 (90\u2013720) minutes. Overall, 29.3% of patients arrived within 1 hour, 41.0% within 2 hours, 48.3% within 3 hours, and 58.5% within 4.5 hours. Facial droop was consistently associated with earlier hospital arrival across multiple time thresholds (p\u00a0\u2264 0.004), and syncope was more frequent among early presenters (p = 0.001). Conversely, visual symptoms were associated with delayed presentation, including vision loss after 3 hours and diplopia beyond 4.5 hours (p = 0.042 for both). Diabetes mellitus was associated with delayed arrival at the 1-hour and 2-hour thresholds, while hypertension was more common among patients arriving after 4.5 hours.\u00a0Prehospital delay remains a substantial barrier to timely acute stroke care. Recognizable symptoms such as facial droop may facilitate earlier presentation, whereas less typical symptoms, particularly visual disturbances, may contribute to delayed arrival. These findings support locally tailored public awareness strategies and optimized prehospital stroke pathways that emphasize both typical and atypical stroke symptoms.<\/jats:p>","DOI":"10.17305\/bb.2026.14308","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:30:50Z","timestamp":1780680650000},"page":"2197-2212","source":"Crossref","is-referenced-by-count":0,"title":["Clinical symptoms associated with prehospital delay in first-ever acute stroke"],"prefix":"10.17305","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2452-1874","authenticated-orcid":false,"given":"Hatice Yelda","family":"Y\u0131ld\u0131z","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0123-4514","authenticated-orcid":false,"given":"Emine","family":"I\u015f\u0131l","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu\u011fba","family":"Yurdakul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zg\u00fcr","family":"Canpolat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do\u011fan","family":"Kaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferda","family":"Kaya Zaman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-5908","authenticated-orcid":false,"given":"Yakup","family":"Krespi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6922","published-online":{"date-parts":[[2026,6,5]]},"container-title":["Biomolecules and Biomedicine"],"original-title":[],"link":[{"URL":"https:\/\/bjbms.org\/ojs\/index.php\/bjbms\/article\/download\/14308\/4216","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjbms.org\/ojs\/index.php\/bjbms\/article\/download\/14308\/4216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:00:43Z","timestamp":1789768843000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjbms.org\/ojs\/index.php\/bjbms\/article\/view\/14308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":0,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,9,16]]}},"URL":"https:\/\/doi.org\/10.17305\/bb.2026.14308","relation":{},"ISSN":["2831-090X","2831-0896"],"issn-type":[{"value":"2831-090X","type":"electronic"},{"value":"2831-0896","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,5]]}}}