Development of a novel mobile application on emergency management contributing to favorable outcomes among acute ischemic stroke patients at county-level hospitals in China: Observational Study (Preprint)

BACKGROUND Timely thrombolytic therapy is crucial for improving the outcomes of acute ischemic stroke (AIS). Mobile technologies have the potential to shorten door to needle time (DNT) and improve the emergency management of AIS. Nevertheless, reports on the use of mobile applications in the emergency management of AIS patients in county-level areas in China are limited. OBJECTIVE This study aimed to evaluate the effectiveness of a new mobile application in improving emergency management efficiency and functional outcomes for AIS patients at county-level hospitals in China. METHODS A retrospective study was conducted at a county-level hospital in Sichuan Province, China, involving 428 AIS patients treated with intravenous thrombolysis between March 2019 and December 2024. The pre-APP group (n=52) was compared with the post-APP group (n=376) after app implementation in August 2020. Univariable logistic regression analysis was employed to assess associations between the new mobile application and the emergency management and functional outcomes of AIS patients. RESULTS Post-APP implementation, median DNT significantly decreased from 52 (42-58) to 38 (31-46) minutes (P<.001). National Institutes of Health Stroke Scale (NIHSS) scores at post-thrombolysis and 24 hours post-thrombolysis were significantly lower in the post-APP group (P<.001). Univariable logistic regression analysis showed that the mobile application was associated with shorter door to blood samples time (OR=0.72, 95%CI=0.65-0.80, P<.001), door to CT time (OR=0.94, 95%CI=0.88-0.99, P=.02), door to CT results time (OR=0.90, 95%CI=0.85-0.94, P<.001), DNT (OR=0.95, 95%CI=0.93-0.97, P<.001) and lower NIHSS scores at post-thrombolysis (OR=0.92, 95%CI=0.89-0.96, P<.001) and 24 hours post-thrombolysis (OR=0.93, 95%CI=0.90-0.96, P<.001). CONCLUSIONS The new mobile application effectively reduced in-hospital treatment delays and improved short-term prognosis of AIS patients in a county-level hospital. These findings indicate the development of mobile health technologies to improve the emergency management for AIS patients in resource-constrained settings. CLINICALTRIAL This study was approved by the ethics committee of the Xichang People’s Hospital (ID: 2025-50). The requirement for informed consent was waived and approved by the ethics committee.