Evaluation of pre- and in-hospital workflows and time intervals with acute ischemic stroke patients

Mikko Helander, Timo Iirola, Pauli Ylikotila, Hilla Nordquist

Abstract

Stroke is one of the leading causes of death and disability globally. Rapid recanalization therapy for acute ischemic stroke (AIS) patients is critical for improving outcome. While in-hospital time intervals have decreased and treatment methods have improved over the past decade, pre-hospital time intervals have remained unchanged.

Introduction

Stroke is one of the leading causes of death and disability worldwide. In 2021, there were 12 million new stroke cases globally, with a prevalence of 94 million, 65% of which were ischemic strokes. Between 1990 and 2021, the global stroke burden increased substantially in absolute numbers.

Materials and Methods

A retrospective register study was conducted using the patient registry from the Wellbeing Services County of Southwest Finland, covering the period of 01/01/2022-31/12/2022. The patient registry includes both pre-hospital and in-hospital care records, and data was collected in 2023.

Results 

A total of 213 patients were identified as having received IVT and/or EVT at TUH between 01/01/2022-31/12/2022. After exclusions, 174 were included in the study (Fig 1). 

Discussion

Numerous factors contribute to time intervals in the treatment pathway for AIS patients, but the ability to accurately recognize AIS symptoms at each stage is crucial. Our findings demonstrate that the likelihood of a favorable outcome decreases with every additional minute from onset to treatment, consistent with previous studies [3–9,21,26].

Conclusion

AIS patients were generally well-identified throughout the phases of the care chain; however, without assessing false positives, it is difficult to fully evaluate the accuracy of this identification.

Citation: Helander M, Iirola T, Ylikotila P, Nordquist H (2025) Evaluation of pre- and in-hospital workflows and time intervals with acute ischemic stroke patients. PLoS ONE 20(4): e0319783. https://doi.org/10.1371/journal.pone.0319783

Editor: Cem Bilgin,, Mayo Clinic, UNITED STATES OF AMERICA

Received: November 1, 2024; Accepted: February 7, 2025; Published: April 22, 2025

Copyright: © 2025 Helander et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data cannot be shared publicly because data contains potentially identifying and sensitive patient information. Data are available from the research services of the Wellbeing Service County of Southwest Finland, (contact via timo.iirola@varha.fi or utilizing the contact information provided at https://www.varha.fi/fi/tietoa-meista/tieteellinen-tutkimus/tutkimuspalvelut) for researchers who meet the criteria for access to confidential data.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.