Evaluation of Diagnostic and Treatment Timelines for Ischemic Stroke Patients in the Emergency Department: A Prospective Observational Study

Background: This study aimed to evaluate the diagnostic and treatment processes of patients presenting with ischemic stroke to the Emergency Department of Eskisehir Osmangazi University Faculty of Medicine Hospital, identify workflow deficiencies, and propose improvement strategies. Methods:This prospective and observational study included 592 patients aged 18 years or older who were diagnosed with ischemic stroke in the emergency department.Demographic data of patients admitted to the emergency department and diagnosed with ischemic stroke, their backgrounds, vital signs at the time of first presentation to the emergency department, emergency department management processes (electrocardiography, fingerstick blood glucose, consultation calls and completion times, Computed tomography (CT) and CT angiography acquisition and reporting times, treatment (intravenous thrombolytic therapy (IV tPA) and endovascular therapy (EVT) initiation times and transfer times to the stroke unit were recorded. Results:The mean age of the patients was 68.2813.09years, and 53.7% were male.Reperfusion therapy (rtPA and/or EVT) was administered to 25.1% of the patients.The mean door-to-doctor time was 2.000.91 minutes, and the mean door-to-CT time was 22.3616.79minutes.Diagnostic and treatment processes were significantly faster in patients receiving reperfusion therapy (P<.001).The primary factor delaying rtPA administration was the arrival time of the consultant physician to the emergency department. Conclusion:Timely and effective management of diagnostic and treatment processes in ischemic stroke patients significantly reduces mortality and morbidity.Coordinated teamwork between emergency and stroke units and process optimization may enhance the success of stroke management.