ArticleMedical sciences (Basel, Switzerland)2025
Association Between Sociodemographic Disparities and Door to Computerized Tomography Time in Patients with Acute Ischemic Stroke Across COVID-19 Periods in the Emergency Department: A Multi-Center Cohort Study.
Article in Medical sciences (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionStroke is the fifth leading cause of death and long-term disability in the United States. The current guideline for stroke management includes a 25 min timeframe from door-to-computed tomography time (DTCT). However, sociodemographic backgrounds may impact the DTCT in acute stroke patients.
methodsThis was a retrospective, multicenter, cohort study between January 2018 and August 2022 throughout North Texas. The primary endpoint was DTCT ≤ 25 min upon arrival to hospital for all patients suspected of acute ischemic stroke.
resultsDuring the study period, a total of 23,364 patients were included. Only 4468 patients (19.1%) had DTCT times less than or equal to 25 min, and 16,464 patients (70.5%) had DTCT times more than 25 min. In our cohort, Black (OR 1.35; 95% CI 1.23-1.49) and Asian patients (OR 1.33; 95% CI 1.01-1.74) were more likely to have DTCT > 25 min compared to White patients. Hispanic patients (OR 1.20; 95% CI 1.07-1.34) were more likely to have DTCT > 25 min compared to non-Hispanics. Patients presenting during the COVID (OR 1.45; 95% CI 1.34-1.57) and post-COVID period (OR 1.46; 95% CI 1.30-1.65) were more likely to have DTCT > 25 min compared to the pre-COVID period.
conclusionsWe demonstrated a discrepancy in DTCT time for acute ischemic stroke patients based on their race and ethnic population and an increase in DTCT time after the start of COVID-19, which has persisted after the pandemic. These diverse factors highlight the complex interplay of logistical, organizational, and healthcare challenges that have influenced DTCT time.
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