Nicole Tovar Acosta, Gabriela Salcedo Garrido, Erwin Hernando Hernandez Rincon
Acute critical conditions such as stroke, severe trauma and sepsis represent major causes of mortality, disability and financial pressure on health systems. In these time-dependent scenarios, computed tomography (CT) and magnetic resonance imaging (MRI) are fundamental for diagnostic and therapeutic decision-making; however, delays in access to imaging may represent structural bottlenecks associated with clinical and health-system outcomes. To map and synthesise the available evidence on the relationship between timely access to CT and MRI and clinical and health system outcomes in acute critical conditions. A scoping review was conducted in accordance with the Joanna Briggs Institute guidelines and reported following PRISMA-ScR. A structured search was performed in PubMed, Scopus, Web of Science and ScienceDirect (January 2010-February 2026). Studies involving patients with stroke, trauma or sepsis that evaluated imaging access metrics and their association with clinical or system outcomes were included. Twenty-seven studies were included. Eleven reported adjusted associations between longer time-to-imaging intervals and adverse clinical outcomes, including higher in-hospital mortality, reduced functional independence or loss of therapeutic eligibility, particularly in stroke and vascular trauma. Eight reported associations with system metrics, such as prolonged hospital length of stay and reduced operational efficiency. The remaining studies identified structural factors associated with diagnostic delay related to care pathway organisation, resource availability and architectural factors. Timely access to CT and MRI may serve as a marker of health-system performance associated with clinical and operational outcomes in acute time-dependent conditions. Incorporating time-to-imaging metrics as potential performance indicators may support the planning and evaluation of acute care delivery.