Patient Delay and Ischemic Stroke Prognosis: A Systematic Review and Meta-Analysis

Area of Science:

• Neurology
• Public Health
• Clinical Medicine

Background:

• Patient delay in seeking treatment for ischemic stroke is a critical factor influencing health outcomes.
• The precise impact of delayed medical attention on the prognosis of ischemic stroke patients requires further elucidation.

Purpose of the Study:

• To conduct a systematic review and meta-analysis to determine the association between patient delay and the prognostic outcomes of ischemic stroke.

Main Methods:

• A comprehensive search of multiple databases (PubMed, Web of Science, Embase, etc.) was performed up to July 24, 2022.
• Included studies were case-control, cohort, and randomized controlled trials, with data extracted and risk of bias assessed by two independent reviewers.
• Meta-analysis was conducted using Revman 5.3.5 software on data from 14 studies involving 25,337 patients.

Main Results:

• Patients experiencing delayed visits had significantly higher rates of mortality (OR=2.03), readmission (OR=8.17), stroke recurrence (OR=2.66), and adverse outcomes (OR=2.07).
• No statistically significant difference was observed in the National Institute of Health Stroke Scale score between delayed and timely visit groups (MD=1.12).

Conclusions:

• Patient delay is a significant determinant of poor prognosis in ischemic stroke, increasing the likelihood of mortality, readmission, recurrence, and adverse events.
• Further research is warranted to validate and expand upon these findings regarding the impact of delayed care on ischemic stroke outcomes.