Intravenous thrombolysis (IVT) improves outcomes in acute ischemic stroke (AIS); however, each minute of delay lessens the potential for neurological recovery. Achieving rapid treatment is therefore critical—patients treated within 45 minutes of arrival have significantly lower mortality, reduced disability, and fewer readmissions.

Retrospective, cross-sectional study of AIS patients receiving IVT between October 2022 and July 2025 (n=60). Sociodemographic, clinical, and operational variables were extracted from medical records. Descriptive and comparative analyses assessed predictors of DTN <45 vs ≥45 minutes, and a rapid IVT prediction model was generated using STATA 19.0.

Higher NIHSS, older age, and longer OTD were associated with faster IVT, whereas EMS arrival, prior stroke, and elevated systolic blood pressure predicted DTN >45 minutes. These findings highlight the need to strengthen both prehospital and in-hospital processes, especially for patients with identifiable risk factors, to ensure timely and equitable acute stroke care.