Complete guide to GCC hospital stroke services — stroke pathway management, thrombolysis, mechanical thrombectomy, stroke unit care, DHA stroke standards, Saudi stroke strategy, and stroke software.
GCC has 50,000+ stroke cases per year. Only 30% arrive within the thrombolysis window. Door-to-needle target is < 45 minutes. 40+ thrombectomy-capable centres. This guide covers GCC stroke services.
Acute Stroke Pathway
- Recognition: FAST (Face, Arms, Speech, Time) — public awareness
- Emergency call: Call ambulance (999 Saudi, 998 UAE)
- Pre-notification: Ambulance pre-notifies hospital — stroke alert activation
- ED triage: Immediate triage, NIHSS assessment, vital signs
- CT scan: Non-contrast CT within 25 minutes of arrival
- Thrombolysis: IV alteplase within 45 minutes (door-to-needle) if eligible
- Thrombectomy: Mechanical thrombectomy for LVO within 6-24 hours
- Stroke unit: Admit to stroke unit for monitoring and care
- Rehab: Early rehabilitation (physio, OT, speech, swallow)
Stroke Service Levels
| Level | Description | Capabilities |
|---|---|---|
| Stroke-ready hospital | Basic stroke care | Thrombolysis, CT, stroke pathway |
| Primary stroke centre (PSC) | Comprehensive stroke care | Thrombolysis, stroke unit, 24/7 CT |
| Comprehensive stroke centre (CSC) | All stroke services | Thrombolysis, thrombectomy, neurosurgery, ICU |
Stroke KPIs
| KPI | Target | GCC Average |
|---|---|---|
| Door-to-CT time | < 25 min | 30-45 min |
| Door-to-needle time | < 45 min | 60-90 min |
| Thrombolysis rate (eligible) | > 80% | 30-50% |
| Thrombectomy rate (LVO) | > 80% | 40-60% |
| Stroke unit admission | > 90% | 60-70% |
| Mortality (ischaemic stroke) | < 15% | 15-20% |
| Functional independence at 90d | > 50% | 35-45% |
Frequently Asked Questions
- What is the stroke burden in the GCC?
- GCC stroke burden: 50,000+ stroke cases per year. Stroke is the #3 cause of death and #1 cause of disability. Incidence: Saudi Arabia — 100/100,000, UAE — 80/100,000. Key risk factors: hypertension (30%), diabetes (20%), smoking (15%), AF (5%). Only 30% of GCC stroke patients arrive within the thrombolysis window (4.5 hours).
- What is door-to-needle time for stroke thrombolysis?
- Door-to-needle time is the time from hospital arrival to thrombolysis administration. Target: < 45 minutes (AHA/ASA). GCC average: 60-90 minutes. Key delays: 1) Delayed recognition, 2) Delayed ED triage, 3) Delayed CT scan, 4) Delayed thrombolysis decision. Every 15-minute delay reduces odds of good outcome by 10%.
- How many thrombectomy-capable centres are in the GCC?
- GCC has 40+ thrombectomy-capable centres: Saudi Arabia — 20+, UAE — 10+, Qatar — 3+, Kuwait — 2+, Bahrain — 2+, Oman — 2+. Mechanical thrombectomy is the standard of care for large vessel occlusion (LVO) stroke within 6 hours (up to 24 hours with imaging criteria). Thrombectomy improves functional outcome by 50%.