Abstract
BACKGROUND: Timely recognition of stroke symptoms is essential for optimizing treatment and improving outcomes. The BE FAST (Balance, Eyes, Face, Arms, Speech, Time) mnemonic is a practical tool designed to enhance early identification of stroke in community and clinical settings. This study aimed to evaluate the clinical impact of implementing the BE FAST method in high-risk populations presenting with suspected acute stroke. METHOD: This retrospective cohort study included 433 patients who presented with acute stroke symptoms between January 2020 and December 2023. Patients were divided into two groups: those assessed using the BE FAST method (n = 212) and those evaluated through standard clinical observation or patient/family reporting (n = 221). Key outcomes included time from symptom onset to hospital arrival, rate of thrombolysis or thrombectomy, neurological improvement based on NIHSS scores, length of hospital stay, and in-hospital mortality. Multivariate logistic regression was used to adjust for potential confounders. RESULTS: Patients in the BE FAST group had significantly shorter median time from symptom onset to hospital arrival (82 min vs. 141 min, p < 0.001), and higher rates of intravenous thrombolysis (35.8% vs. 23.1%, p = 0.004). Neurological improvement (NIHSS score improvement ≥4 at discharge) was observed in 61.3% of BE FAST group patients versus 39.8% in the control group (p < 0.001). The BE FAST group also had a lower in-hospital mortality rate (3.8% vs. 7.7%, p = 0.047) and shorter average hospital stays (6.2 ± 2.5 days vs. 8.1 ± 3.0 days, p < 0.001). BE FAST use remained an independent predictor of favorable neurological outcomes after adjustment for age, sex, comorbidities, and initial stroke severity. CONCLUSION: The use of the BE FAST method significantly improves early stroke recognition, facilitates timely intervention, and is associated with better clinical outcomes in high-risk populations. Widespread implementation of this tool in both pre-hospital and clinical settings may enhance stroke care pathways and reduce disability and mortality.