Sevinç ERDEM, Engin ÖZAKIN, Nurdan ACAR, Muhammed Evvah KARAKILIÇ, Filiz Baloğlu KAYA, Mustafa Emin ÇANAKÇI, Atilla Özcan ÖZDEMİR, Özlem AYKAÇ, Veli Görkem PALA, Yağmur AY, Seher Sezin YILMAZ
Turkish Journal of Cerebrovascular Diseases - 2026;32(1):42-50
Introduction: The global disruption to healthcare systems caused by the pandemic has had a particular impact on time-sensitive emergencies such as acute ischaemic stroke. This study aimed to evaluate the impact of the pandemic on the pre-hospital and hospital management of acute ischemic stroke patients receiving recanalisation therapies. Methods: This single-center retrospective study compared 227 pre-pandemic (2019-2020) and 206 pandemic-era (2020-2021) aIs patients treated with intravenous thrombolysis (IV rt-P a) or mechanical thrombectomy (MT). Data included demographics, time metrics (e.g., onset-to-door, door-to-needle), NIhss/mRs scores, and outcomes. Results: a total of 433 patients were included in the study; 227 were treated pre-pandemic, and 206 were treated during the pandemic. No significant differences were found in the demographic characteristics of the patients in the two periods. During the pandemic, we observed a decline in MT referrals from other centres, as well as a shift in ambulance usage patterns. a mong IV rtP a patients, eMs dispatch time decreased while scene and hospital delivery times increased (P<.01). Door-to-CT and door-to-needle times were prolonged in both groups during the pandemic (P<.05). The proportion of patients receiving IV rtP a within the 0-3-hour window remained stable. NIhss scores at admission increased significantly in the MT group (P=.005). Functional outcomes and mortality worsened significantly in the IV rtP a group during the pandemic (P<.05), whereas outcomes in the MT group remained unchanged. Discussion and Conclusion: The negative impact of the pandemic on several components of acute ischaemic stroke care, particularly prehospital timelines and emergency department efficiency in cases involving IV rtP a, contributed to poorer functional outcomes. These findings emphasise the importance of maintaining stroke care pathways and preparedness strategies during public health emergencies.
