Acute stroke care protocol: an analysis of care times in the Institute of Mexican Social Security Hospitals

Antonio Reyna-Sevilla, Unidad de Educación e Investigación, Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social (IMSS), Alcaldía Cuauhtémoc, Mexico City, Mexico
Jonathan I. Colín-Luna, División de Excelencia Clínica, Coordinación de Innovación en Salud, Unidad de Planeación e Innovación en Salud, Dirección de Prestaciones Médicas, IMSS, Mexico City, Mexico
Héctor Patiño-Rubio, División de Excelencia Clínica, Coordinación de Innovación en Salud, Unidad de Planeación e Innovación en Salud, Dirección de Prestaciones Médicas, IMSS, Mexico City, Mexico
David R. Bustamante-Rojo, Área de Prestaciones Económicas y Sociales, Órgano de Operación Administrativa Desconcentrada Sinaloa, IMSS , Culiacán, Sinaloa, México
Miguel Galarde-López, Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias, Mexico City, Mexico
Juan H. Medina-Chávez, Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias, Mexico City, Mexico

Objectives: In Mexico, nationwide evidence on stroke medical care protocols remains limited, particularly regarding care times, treatment, and hospitalization. Therefore, this study aimed to analyze and report stroke care response times in the Institute of Mexican Social Security hospitals. Methods: We conducted a cross-sectional study using nationally reported stroke cases from secondary and tertiary hospitals across all 32 states of Mexico between January 2022 and May 2025, in a population aged ≥ 20 years. Absolut=e and relative frequencies of door-to-stroke-team, door-to-computed tomography (CT) scan, and door-to-needle times were analyzed and compared with international recommendations. Spatial distribution, overall temporal trends, and stroke patterns were also assessed. Results: A total of 10,451 stroke cases were recorded, predominantly ischemic subtype (63.1%) and in the 61-70 age group. Among the eligible population, care times were as follows: door-to-stroke-team ≤ 10 min in 62.14%, door-to-CT scan ≤ 30 min in 40.06%, and door-to-needle ≤ 60 min in 73.75%. Hospitals located in highly urbanized municipalities accounted for the highest stroke care burden (40.60%). Although the overall trend showed an increase, a higher number of cases were reported during the early months of each year (p < 0.05). Conclusions: Although door-to-stroke-team and door-to-needle times were consistent with international recommendations, our findings underscore the need to reduce the time between symptom onset, emergency admission, and CT scanning, and address the factors that delay the implementation of recommended interventions. Strengthening healthcare institutions in Mexico through a medical care protocol and coordinated, standardized activities is essential to increase the availability of specialized stroke care centers.

Keywords: Stroke. Ischemic stroke. Emergency treatment. Emergency medical services. Mexico.