ABSTRACT NUMBER: ESOC2026A2237 DOOR-IN DOOR-OUT TIMES PRIOR TO TRANSFER FOR MECHANICAL THROMBECTOMY, A SINGLE-CENTER OBSERVATIONAL STUDY (DIDO-MT)

Abstract Background and aims In acute stroke, every 30-minute delay increases disability and three-month mortality by 20%. In France, 60% of severe strokes require transfer to another hospital for mechanical thrombectomy (MT). The “Door-in Door-out” (DIDO) interval - time spent in the first hospital - should be under 90 minutes according to French HAS 2025 guidelines, or under 120 minutes according to US recommendations. This interval remains insufficiently documented. This study aimed to describe DIDO performance in a French hospital and identify factors associated with prolonged delays. Methods We conducted a retrospective single-center observational study including patients initially managed at Meaux City Hospital, then transferred to Rothschild Foundation Hospital, Paris for MT between January 2021 and December 2024. Data were extracted from electronic medical records and analyzed descriptively. Factors associated with prolonged DIDO (≥120 minutes) were assessed using univariate analysis. Results Among 184 identified patients, 99 were included due to missing departure-time data. The median DIDO was 120 minutes [96–156], with 30 minutes from arrival to imaging and 90 minutes from imaging to departure. Only daytime arrival (8:00–20:00) was significantly associated with a DIDO <120 minutes. No association was found with medical history, NIHSS score, or intravenous thrombolysis. Nineteen percent of patients met the French recommended target (<90 minutes). Conclusions DIDO performance was substantially above recommended thresholds. Evening admissions and delays between imaging and departure were major contributors. Improved documentation, optimized post-imaging workflows, and strengthened off-hours staffing may help reduce DIDO times. Conflict of interest Boursin: nothing to disclose. Bonnerave: nothing to disclose. Ameri: : nothing to disclose. Saintonge: nothing to disclose. Seners: nothing to disclose. Mazighi: nothing to disclose.