Abstract Details

Title Time to Imaging and Functional Outcomes: Visualizing Predictive Trends between Door-to-Imaging, NIHSS, and mRS

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-014

Objective Correlate door-to-imaging time (DIT) with functional status at discharge, and visualize predictive trends involving DIT, NIHSS, and modified Rankin Scale (mRS).

Background Acute ischemic stroke (AIS) is a leading global cause of death where prompt management is vital; guidelines recommend imaging within 25 minutes of hospital arrival^1,2. Delays in stroke patients’ care negatively affect outcomes, particularly in resource-limited settings, making it crucial to understand the impact of diagnostic imaging time on prognosis.

Design/Methods Retrospective longitudinal study of AIS patients at a stroke unit in the Dominican Republic from January to September 2024. Data from electronic records included demographics, NIHSS, DIT, and discharge mRS. Descriptive statistics summarized data, and ordinal logistic regression (OLR) evaluated the relationship between DIT and mRS, adjusting for age, sex, delta NIHSS, and reperfusion therapy. Predicted margins analyzed trends for each mRS category. Analyses were performed in STATA.B18, with significance at p=<.05 and mean imputation for missing data.

Results The study registered 150 patients (mean age of 67.5 years [±15.52], 59.3% male, 42.7% with DIT ≤25-minutes). OLR showed that each additional minute in DIT slightly decreased the odds of worse mRS scores (OR=0.999, CI=0.999–1.000, p=.075). Adjusting for age and reperfusion therapy produced similar findings, while increases in age and reperfusion raised the odds of worse mRS outcomes by 2.9% (OR=1.03, CI=1.009–1.053, p=.006) and 36% (OR=1.36, CI=0.496-3.727, p=.550), respectively. Each unit decrease in NIHSS from admission to discharge decreased the odds of a worse outcome by 7.6% (OR=0.924, CI=0.843-1.014, p=.096). Male patients had 66.3% higher odds of greater mRS scores, but this was not statistically significant (OR=1.663, CI=0.913-3.030, p=.096).

Conclusions DIT did not significantly impact outcomes, but NIHSS and age were strong predictors, suggesting that symptom severity at admission may be more critical for stroke outcomes. These insights can aid resource-limited countries in developing strategies to address treatment delays, improving patient care.

Authors/Disclosures
Sabrina M. Lora, MD (CEDIMAT) PRESENTER	Miss Lora has nothing to disclose.
María Cedeño-Bruzual, MD	Dr. Cedeño-Bruzual has nothing to disclose.
Ramon A. Romano Peralta, MD	Dr. Romano Peralta has nothing to disclose.
Stephanie Castro Turbi, MD (CEDIMAT)	Dr. Castro Turbi has nothing to disclose.
Cesarina L. Torres Vásquez, MD (PUCMM)	No disclosure on file
Francisco A. Mendez, Sr., MD	Dr. Mendez has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Menarini.
Edwina L. Luna Rodríguez, MD (CEDIMAT)	Dr. Luna Rodríguez has nothing to disclose.

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