Evaluating the timeliness of care: delayed presentation and its predictors among patients with ischemic stroke at a tertiary care hospital in Northern Ethiopia

Stroke is a leading cause of morbidity and mortality worldwide, with ischemic stroke being the most common subtype. Timely presentation is critical for optimal management and improved outcomes. A prospective observational study was conducted at the University of Gondar Comprehensive Specialized Hospital from July to September 2022. Time from symptom onset to hospital arrival and factors associated with delayed presentation were assessed. Data were collected using a structured questionnaire, entered into EpiData version 4.6, and analyzed using SPSS version 23. A total of 200 ischemic stroke patients were included, with a median age of 65 years (IQR: 20 years), and 57.5% were female. Most patients (71.0%, n = 142) presented after the 4.5-hour therapeutic window. The median time to presentation was 12 h (IQR: 4 h). Factors associated with delayed presentation included distance greater than 30 km from the hospital, non-vehicle transportation, absence of a caretaker or bystander, absence of altered mentation as an initial symptom, and lack of prior stroke awareness. A high proportion of patients presented late, limiting eligibility for reperfusion therapy. Interventions to improve stroke awareness, transportation systems, and early symptom recognition are essential.