A Comprehensive Assessment of Acute Stroke Care: Delays, Treatment Patterns, and Barriers to Timely Intervention

The study aimed to evaluate delays in emergency department (ED) arrival among stroke patients and to identify demographic factors that contribute to these delays. It was a cross-sectional study conducted at the Department of Neurology, Liaquat National Hospital, Karachi, Pakistan, from January to July 2024. A total of 174 patients attending the ED for acute stroke were interviewed. There were 112 men and 62 women, with a mean age of 60.54 ± 12.74 years. One hundred and twenty-six (72.4%) of these patients presented to the ED more than four hours after the onset of stroke symptoms. Factors associated with late arrivals included education level (p <0.001), place of residence (p = 0.043), distance travelled (p <0.001), stroke onset time (p = 0.002), referral from another hospital (p <0.001), and awareness of facilities providing acute stroke care (p <0.001). More than half of patients failed to reach the critical window for thrombolysis because of delays in arrival. Contributing factors comprise insufficient awareness and challenges in accessing care. Prompt community-focused measures are imperative to tackle these issues effectively. Key Words: Stroke, Emergency services, Thrombolytic therapy, Demography, Educational status.