{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:03:36Z","timestamp":1792807416532,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Acute ischemic stroke (AIS) is a major cause of mortality and disability worldwide, requiring rapid intervention to prevent brain damage. Timely thrombolytic therapy with tissue plasminogen activator (tPA) is essential but often underutilized due to barriers in treatment delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to identify barriers impacting the timely administration of thrombolytic therapy in AIS patients at a major tertiary care hospital in Riyadh, Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study included adult patients with AIS who were admitted to the Emergency Department (ED) of King Abdulaziz Medical City, Riyadh, between November 2015 and March 2023. Patient demographics, clinical characteristics, and records on ED arrival time were reviewed to identify barriers to thrombolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 576 patients were included in the study (mean age: 64 \u00b1 13 years; male: 65%). The mean National Institutes of Health Stroke Scale score at presentation to the ED was 7.3, indicating a moderate level of severity among stroke patients. The study found that delayed ED arrival (77%) and current anticoagulant use (34%) were the main barriers to thrombolysis. The most common symptoms were weakness (77%), slurred speech (62%), and facial droop (28%). Only 10% of patients received thrombolytic therapy, of which 70% received an appropriately calculated dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Delayed emergency department arrival and recent use of anticoagulants significantly impact timely thrombolysis for acute ischemic stroke in Saudi Arabia. Prospective multi-center studies are recommended to further explore these barriers across varied healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjmms.sjmms_708_24","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T17:03:54Z","timestamp":1760461434000},"page":"307-311","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Barriers to Rapid Stroke Thrombolysis at a Large Tertiary Care Hospital in Riyadh, Saudi Arabia"],"prefix":"10.4103","volume":"13","author":[{"given":"Mohammed","family":"Alrashed","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"},{"name":"Department of Pharmaceutical Care Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layan","family":"Alarifi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahlam","family":"Almutairi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mada","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah S.","family":"Alshammari","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical 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