Purpose: Timely medical attention is crucial for patients with Acute Ischemic Stroke (AIS), as delays can significantly impact therapeutic outcomes. These delays are influenced by a combination of socio-cultural, educational, and clinical factors.
Patients and Methods: An in-depth analysis was conducted to assess the prevalence and median duration of healthcare-seeking delays in AIS patients. The study specifically investigated the independent impacts of sociocultural and clinical determinants on these delays, with a focus on immigrant status, gender disparities, and educational levels. Multivariate regression analysis was employed to identify these independent effects while controlling for potential confounding factors.
Results: Among 1419 AIS patients, 82.52% (n = 1171) experienced delays exceeding 2 hours from symptom onset of symptoms to hospital arrival. The median delay was 12.3 hours. Immigrant populations encountering longer delays compared to native groups. Younger males (< 45 years) and elderly females were more prone to delay in healthcare-seeking. Identified independent risk factors for delay included male gender (OR = 1.65 [95% CI:1.14− 2.48]), self-acknowledged diabetes (OR = 2.50 [95% CI:1.21– 5.17]), small vessel (OR = 2.07 [95% CI:1.27– 3.36]), and wake stroke (OR = 7.04 [95% CI:3.69– 13.44]). Educational background (high school and above), GCS score with 3– 8 points (OR = 0.52 [95% CI:0.09– 0.69]), understanding stroke-related knowledge (OR = 0.26 [95% CI:0.09– 0.44]), conscious disturbance (OR = 0.25 [95% CI:0.10– 0.62]) and limb weakness (OR=0.21[95% CI:0.21– 0.49]) are protective factors for timely treatment.
Conclusion: Immigrant populations experienced longer delays from symptom onset to hospital arrival. The crucial roles of education and knowledge about stroke underscore the need for enhanced health literacy campaigns and public awareness, with a targeted focus on younger males and elderly females.

Keywords: healthcare-seeking behavior, immigrant population, educational disparity, pre-hospital delay, AIS