Impact of a prolonged nationwide residents’ strike on acute ischemic stroke care in a metropolitan city

Background Acute ischemic stroke (AIS) requires timely management in both prehospital and in-hospital phases to optimize outcomes. In 2024, South Korea experienced a prolonged nationwide residents’ strike that disrupted the healthcare system, potentially affecting AIS management. This study evaluated the impact of the residents’ strike on time-to-management outcomes in patients with AIS. Methods We performed a retrospective multicenter study of AIS patients who presented within 24 hours of symptom onset to six major hospitals in Daegu, South Korea, between March and December in both 2023 and 2024. Clinical characteristics and management times were compared according to strike status and further analyzed by dividing patients into early and late strike phases. Results A total of 2,059 AIS patients were included. During the late phase of the residents’ strike, patients transported by 119 public emergency medical service dispatches experienced delayed hospital arrival (83 minutes vs. 98 minutes, p  = 0.003). Logistic regression analysis further demonstrated that the late phase of the strike was associated with significant delays in intravenous thrombolysis initiation (adjusted odds ratio, 0.48; 95% confidence interval, 0.25–0.95). Conclusion The prolonged residents’ strike in South Korea resulted in delays in AIS management, particularly during the late phase, impacting both prehospital transport by 119 public emergency medical service dispatches and timely intravenous thrombolysis administration.