Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 55 1 2026 02 07 63 75 Ningning Dai Department of Emergency Medicine, the Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China Dan Zhao Department of Emergency Medicine, the Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China Dongmei Yang Department of Emergency Medicine, the Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China Jing Qian Department of Emergency Medicine, the Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China Zeyu Xie Department of Emergency Medicine, the Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China Maling Xiang Department of Emergency Medicine, the Fourth Affiliated Hospital of Soochow University, Suzhou Dushu Lake Hospital, Medical Center of Soochow University, Suzhou, China 2025 01 17 2025 09 09 Background: A meta-analysis study was implemented to review the comparison of the impact of improving emergency care on the prognosis and treatment rate of elderly patients in the emergency department who have acute strokes. Methods: An inclusive literature investigation was completed until April 2025, and 1765 related studies were reviewed. The 12 selected studies encompassed 1300 elderly patients in the emergency department who had acute strokes. The dichotomous or continuous methodologies with a fixed or random model were used to assess the comparison of the impact of improving emergency care on the prognosis and treatment rate of elderly patients in the emergency department who have acute strokes using odds ratios (ORs), mean difference (MD), and 95% confidence intervals (CIs). Results: First-aid nursing had significantly lower rescue time (MD, -11.16; 95% CI, -15.74- -6.58, P<0.001), fatality rate (OR, 0.26; 95% CI, 0.16-0.43, P<0.001), and disability rate (OR, 0.30; 95% CI, 0.15-0.58, P<0.001) compared to control in elderly patients in the emergency department who have acute strokes. Conclusion: First-aid nursing had significantly lower rescue time, fatality rate, and disability rate compared to control in elderly patients in the emergency department who have acute strokes. Nevertheless, since most of the studies nominated for evaluation in the meta-analysis had low sample sizes, care must be taken when working with their values. https://ijph.tums.ac.ir/index.php/ijph/article/view/37860 https://ijph.tums.ac.ir/index.php/ijph/article/download/37860/8747