ISC 2026 | The impact of door-in-door-out times on outcomes in patients with acute ischemic stroke

I just talked about how important it is to have efficient processes if you are going to transfer a patient and you receive a patient who now realizes they need an advanced treatment like endovascular thrombectomy. So what this paper tried to do was assess the impact of door-in, door-out, which is the time of a person hitting your emergency room door to the time they leave your emergency room en route to the comprehensive or the thrombectomy-capable center. And what we learned and we hypothesized this and what we found was that the longer your door-in, door-out time, the worse your functional outcome was at discharge from the comprehensive or thrombectomy-capable center. So the time that you lose in transferring a patient at the first hospital has a direct and independent effect on the functional recovery of that patient in terms of walking and disability. And it led to a greater risk of complications if you had longer times. And finally, it also meant some people weren’t even getting thrombectomy because the delay was so long that they ended up having a time lapse beyond the window that they would be eligible for that thrombectomy treatment. So not only are your outcomes worse when you do get thrombectomy by increasing your time, you actually could be not eligible at all for it because too much time went by.

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