Dear Editor, Reperfusion therapy using tissue plasminogen activator (tPA) improves the clinical outcome in stroke; however, it should be applied during the first 4.5 h. Only less than 30% of patients arrive at the hospital on time mainly due to a prehospital delay. 1,2 Prehospital delay is analyzed as onset-to-door time, which is divided into onset-to-alarm time (OAT), that corresponds to the time since the patient or the witness identified stroke symptoms until the decision to look for medical attention, and transfer time (Figure 1). More than 50% of the delay corresponds to OAT. 3 Factors associated to OAT vary in every population. We conducted a study to describe the OAT in our population and factors that contribute to a delay in hospital arrival. A retrospective, observational study was performed at the Department of Neurology of the University Hospital UANL in Monterrey, Mexico. Clinical and demographical data were obtained from a Stroke Clinical Registry (iReNe). 4 All patients diagnosed

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