Key result
Door-to-CT time ≤25 minutes linked to ~22-point higher thrombolysis eligibility in acute stroke.
Why the study?
Timely intervention in acute stroke is crucial for favorable outcomes, but performance of door-to-CT time and thrombolysis eligibility in this setting was not well characterized.
Does adherence to rapid door-to-CT time metrics and intravenous thrombolysis administration improve early functional outcomes in acute stroke patients?
Observational (n=310)
No
Does adherence to rapid door-to-CT time metrics and intravenous thrombolysis administration improve early functional outcomes in acute stroke patients?
Absolute Event Rate: 45.8% vs 23.9%
p-value: p=<0.01
Achieving a door-to-CT time of ≤25 minutes significantly increases eligibility for thrombolysis, which in turn improves functional outcomes at discharge for patients with acute stroke.
May support door-to-CT ≤25 min targets in acute stroke; extends observational data on thrombolysis eligibility but requires prospective validation.
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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Farrukh et al. (2025) conducted an observational in Acute stroke (n=310). Door-to-CT time ≤25 minutes vs. Door-to-CT time >25 minutes was evaluated on Eligibility for intravenous thrombolysis (p=<0.01). In patients with acute stroke, achieving a door-to-CT time of ≤25 minutes was significantly associated with a higher rate of eligibility for intravenous thrombolysis (45.8% vs 23.9%, p < 0.01).
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