ArticleCureus2025
Optimizing Stroke Pathways: An Observational Audit of Door-to-CT Time, Thrombolysis, and Clinical Outcomes.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background Stroke is a leading cause of disability and mortality worldwide, where timely intervention is crucial for favorable outcomes. This study aimed to evaluate door-to-CT time performance, eligibility for intravenous thrombolysis, and associated clinical outcomes in patients with acute stroke. Methodology This prospective observational study was conducted at Shalamar Hospital, Lahore, Pakistan, from February 2023 to February 2025. A total of 310 consecutive patients presenting with acute stroke symptoms were enrolled. Door-to-CT time, thrombolysis eligibility, and treatment details were recorded. Clinical outcomes were assessed at discharge using the modified Rankin scale (mRS). Results A total of 310 patients with clinically suspected stroke were enrolled in the study. The mean age of the patients was 61.4 ± 12.6 years, with 182 (58.7%) being male. Hypertension (225, 72.6%) and diabetes mellitus (138, 44.5%) were the most frequent comorbidities. A total of 201 (64.8%) patients underwent CT scanning within 25 minutes of arrival (door-to-CT time). Thrombolysis eligibility was established in 118 (38.1%) patients, of whom 96 (31.0% of the cohort) received intravenous recombinant tissue plasminogen activator (rt-PA). The mean door-to-needle time was 52.7 ± 14.6 minutes, with 71 (74%) of the treated patients achieving the <60-minute benchmark. Favorable outcomes (mRS score = 0-2) were observed in 50 (52.1%) thrombolysed patients compared to 71 (33.2%) non-thrombolysed patients (p < 0.01). Symptomatic intracerebral hemorrhage occurred in 6 (6.2%) treated patients, while overall in-hospital mortality was 34 (11.0%). Conclusions Achieving timely door-to-CT imaging significantly increases the likelihood of thrombolysis eligibility, while intravenous rt-PA improves functional outcomes with acceptable safety.
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