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Status of emergency medical service use for acute ischemic stroke in China
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  • Published: 06 April 2026

Status of emergency medical service use for acute ischemic stroke in China

  • Wenwei Qi1,2,
  • Ying Su3,
  • Jiarui Wu4,
  • Xin Shi5,
  • Xiaohong Wu6,7,
  • Feng Chi6,7,
  • Runyu Xia4,7,
  • Limin Qin6,7,
  • Liming Cao6,8,
  • Yan Yang9,
  • Qin Liu10,
  • Xiaoxiang Peng11,
  • Guobing Huang12,
  • Jinyan Chen13,
  • Yidong Xue14,
  • Wenbiao Guan15,
  • Dan Gao16,
  • Bin Ye17,
  • Tianxia Yu18,
  • Runxiu Zhu19 &
  • …
  • Lijie Ren6,7 

, Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

The current status of emergency medical service (EMS) use among patients with acute ischemic stroke (AIS) in China is a concern. We aimed to understand the status of EMS use and influencing factors in patients with AIS in China. In this large-scale prospective multicenter hospital-based registry study, we evaluated the data of 10,856 patients with AIS admitted to 21 hospitals across different economic and geographic regions in China in 2022. The primary outcome was the proportion of patients arriving at the hospital via EMS. In patients with AIS who arrived independently and those who arrived via EMS, 79.9% and 47.1%, respectively, had an onset-to-door time > 3 h; 16.0% and 40.6%, respectively, received intravenous thrombolysis; and 4.0% and 15.5%, respectively, underwent thrombectomy. Factors promoting EMS use included older age, residence in a small city, wake-up stroke, cardioembolic stroke, and National Institutes of Health Stroke Scale scores 5–15 and 16–42 after onset. Conversely, small-artery occlusion was associated with patients arriving to hospital independently. Hospital arrival via EMS significantly reduced prehospital delay and increased thrombolysis rate compared to arriving at the hospital independently. Improving public education regarding the advantages of using EMS is needed.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge the support of the “Double-First Class” Application Characteristic Discipline of Hunan Province (Pharmaceutical Science). This study was supported by Noncommunicable Chronic Diseases-National Science and Technology Major Project (NO. 2023ZD0504800, 2023ZD0504802), the Research and Promotion Project on Appropriate Intervention Techniques for High-Risk Stroke Population in China (No. GN-2020R0002), the Shenzhen Medical-Preventive Integration (Neurological Diseases) Program, and Shenzhen Clinical Research Center for Neurological Diseases(NO. SCRCND202503[Open Project],and NO. LCYSSQ20220823091204009). The funders provided the article processing charge, but did not contribute to the study in any other way.

Author information

Authors and Affiliations

  1. National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China

    Wenwei Qi

  2. National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Wenwei Qi

  3. Department of Neurology, The People’s Hospital of Gaoming District of Foshan City, Foshan, China

    Ying Su

  4. School of Medicine, Shenzhen University, Shenzhen, China

    Jiarui Wu & Runyu Xia

  5. School of Health Management Institute of Health Sciences, China Medical University, Shenyang, China

    Xin Shi

  6. Department of Neurology, The First Affiliated Hospital of Shenzhen University, 3002 Sungang West Road, 518000, China, Futian, Shenzhen

    Xiaohong Wu, Feng Chi, Limin Qin, Liming Cao & Lijie Ren

  7. Department of Neurology, Shenzhen Second People’s Hospital, Shenzhen, China

    Xiaohong Wu, Feng Chi, Runyu Xia, Limin Qin & Lijie Ren

  8. Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, China

    Liming Cao

  9. Department of Neurology, Fushun Central Hospital, Fushun, China

    Yan Yang

  10. Department of Neurology, The Second People’s Hospital of Yibin, Yibin, China

    Qin Liu

  11. Department of Neurology, The Third People’s Hospital of Hubei Province, Wuhan, China

    Xiaoxiang Peng

  12. Department of Neurology, Yichun People’s Hospital, Yichun, China

    Guobing Huang

  13. Department of Neurology, Beihai People’s Hospital, Beihai, China

    Jinyan Chen

  14. Department of Neurology, Yanan University Affiliated Hospital, Yanan, China

    Yidong Xue

  15. Department of Neurology, The First Hospital of Baiyin City, Baiyin, China

    Wenbiao Guan

  16. Department of Neurology, Chaoyang Central Hospital, Chaoyang , China

    Dan Gao

  17. Department of Neurology, The Third People’s Hospital of Bengbu, Bengbu, China

    Bin Ye

  18. Department of Neurology, Yantaishan Hospital , Yantai, China

    Tianxia Yu

  19. Department of Neurology, Inner Mongolia People’s Hospital, Hohhot, China

    Runxiu Zhu

Authors
  1. Wenwei Qi
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  2. Ying Su
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  3. Jiarui Wu
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  6. Feng Chi
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Contributions

LC and LR conceptualized and designed the study and acquired funding; they contributed equally to this work. WQ and YS performed the statistical analyses. WQ, YS, and JW drafted the manuscript; they contributed equally and share the first authorship. LC also critically reviewed the manuscript. XS, XW, and FC provided administrative support and supervised the study. JW, RX, and LQ provided technical or material support. YY, QL, XP, GH, JC, YX, WG, DG, BY, TY, and RZ acquired data.

Corresponding authors

Correspondence to Liming Cao or Lijie Ren.

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Qi, W., Su, Y., Wu, J. et al. Status of emergency medical service use for acute ischemic stroke in China. Sci Rep (2026). https://doi.org/10.1038/s41598-026-47263-6

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  • Received: 03 July 2025

  • Accepted: 31 March 2026

  • Published: 06 April 2026

  • DOI: https://doi.org/10.1038/s41598-026-47263-6

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Keywords

  • Ischemic stroke
  • Prospective studies
  • Emergency medical services
  • Hospitals
  • Registries
  • Thrombectomy
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