@article{MAKHILLRJMS2024181231832,
    title = {Barriers to Timely Stroke Thrombolysis in Northeast India: A Qualitative Audit from A Tertiary Care Center},
    journal = {Research Journal of Medical Sciences},
    volume = {18},
    number = {12},
    pages = {881-884},
    year = {2024},
    issn = {1815-9346},
    doi = {makrjms.2024.12.881.884},
    url = {https://makhillpublications.co/view-article.php?issn=1815-9346&doi=makrjms.2024.12.881.884},
    author = {Akshay,Payyavula,Sudha,Marami and},
    keywords = {Thrombolysis, Sociocultural barriers},
    abstract = {Timely thrombolysis significantly improves functional outcomes in acute
ischemic stroke. However, implementation remains suboptimal in
low‐resource settings. To identify real‐world barriers delaying intravenous
thrombolysis in ischemic stroke patients in Northeast India. This
prospective observational study was conducted at the Department of
Neurology, GMCH Assam, between January 2023 and March 2024. We
included 444 ischemic stroke patients presenting within 24 hours of
symptom onset, of whom 29 underwent thrombolysis. Barriers were
identified through patient interviews, medical records, and care provider
documentation. Primary outcomes were patient‐, system‐, and
hospital‐related delays preventing thrombolysis. Frequencies and
thematic narratives were compiled. Among 444 patients, only 29 (6.5%)
received thrombolysis. The most common barriers were delayed arrival
beyond the 4.5‐hour window (63%), lack of symptom awareness (52%),
ambulance unavailability (38%), imaging and consent delays (22%), and
elevated blood pressure (17%). Financial constraints were a factor in 11%.
Most patients originated from rural areas. Real‐world barriers continue
to hinder thrombolysis implementation in India. Public education,
prehospital care reforms, and streamlined stroke protocols are crucial to
improving outcomes in underserved regions.}
    }