Evidence map›Paper›PMID 41913141›Full record

ArticleBMC neurology2026

Determinants and long-term outcomes of treatment delays in young and middle-aged acute ischemic stroke patients: a prospective cohort study.

H C Lin, Z X Liu, Y C Wu, K Lin, Z L Liu, D L Chen, Y X Zheng, M M Cai, S H Xie, Z Y Jin and 2 more

Abstract read
In one paragraph

Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

H C Lin *Department of Nursing, Shantou University Medical College, Shantou, Guangdong, China.
Z X Liu *Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Jinping District, Shantou, Guangdong, China.
Y C WuDepartment of Nursing, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
K LinDepartment of Nursing, Shantou University Medical College, Shantou, Guangdong, China.
Z L LiuDepartment of Neurology, The First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Jinping District, Shantou, Guangdong, China.
D L ChenDepartment of Nursing, Shantou University Medical College, Shantou, Guangdong, China.
Y X ZhengOperating room, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
M M CaiDepartment of Nursing, Shantou University Medical College, Shantou, Guangdong, China.
S H XieDepartment of Neurology, The First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Jinping District, Shantou, Guangdong, China.
Z Y Jin *Operating room, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
S Q Chen *Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Jinping District, Shantou, Guangdong, China. chensq510@126.com.
H Zhang *Department of Nursing, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China. halen.zhang@163.com.ORCID http://orcid.org/0009-0006-6563-3484

Funding

Guangdong Nursing Association Research Fund Project GDHLYJYB202430Guangdong Provincial Medical Research Fund Project A2023174the Guangdong Provincial Medical Research Fund Project B2025315
6 · The paper itself

Abstract

background and purposeTreatment delays critically affect outcomes in acute ischemic stroke (AIS). This study investigates predictors of delayed hospital presentation and its long-term impact in young/middle-aged AIS patients.

methodsIn this prospective longitudinal study, 488 consecutive AIS patients (18–59 years old), admitted to our tertiary hospital (June 2021-February 2024), based on the onset-to-needle time for intravenous thrombolysis (IVT) ≤ 4.5 h or the onset-to-groin puncture time for endovascular thrombectomy (EVT) ≤ 24 h for inclusion in a timely-treatment group and other patients in a delayed-treatment group. Multimodal assessments included socioeconomic surveys, NIHSS scores, and followed up with modified Rankin Scale (mRS) and Stroke-Specific Quality of Life Scale (SS-QOL) at 1 and 6 months after onset. Multivariable logistic regression identified delay predictors.

resultsAmong 488 eligible patients (mean age 52.07 ± 6.68 years), 448 (91.8%) experienced treatment delays. Lower monthly income (OR = 3.76, 95%CI = 1.10–4.48), extended hospital distance (OR = 2.86, 95%CI = 1.31–6.24), and illness during non-working hours (OR = 5.85, 95%CI = 2.39–14.36). first visit medical facility is a non-three level hospital(OR = 3.87, 95%CI = 1.47–10.16), non-emergency admission (OR = 27.99, 95%CI = 3.55-220.86), and higher NIHSS score (OR = 0.81, 95%CI = 0.74–0.90) were associated with treatment delay. The negative impact of treatment delay on patient prognosis and quality of life shows a strengthening trend over time. Delayed presentation correlated with poorer 6-month outcomes: higher mRS scores (β = 0.41, P < 0.05) and reduced SS-QOL (ρ=-0.38, P < 0.05).

conclusionsOver 90% of young/middle-aged AIS patients experience treatment delays driven by socioeconomic barriers (low income, geographic constraints) and atypical symptom profiles. The negative impact of treatment delay on prognosis and quality of life strengthens over time. These findings advocate for targeted public health interventions addressing financial/geographic disparities and enhancing recognition of subtle stroke manifestations in the younger populations.

Indexed as

Ischemic StrokeTime-to-TreatmentAdolescentAdultBrain IschemiaFemaleFibrinolytic AgentsHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesQuality of LifeThrombolytic TherapyTreatment DelayTreatment OutcomeFibrinolytic AgentsIschemic strokePrognosisQuality of lifeTreatment delayYoung and middle-aged

Identifiers

PMID41913141
PMCPMC13154868

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.