Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission.
- Author:
Sang Chul KIM
1
;
Keun Sik HONG
;
Seon Il HWANG
;
Ji Eun KIM
;
Ah Ro KIM
;
Joong Yang CHO
;
Hee Kyung PARK
;
Ji Hyun PARK
;
Ja Seong KOO
;
Jong Moo PARK
;
Hee Joon BAE
;
Moon Ku HAN
;
Dong Wha KANG
;
Mi Sun OH
;
Kyung Ho YU
;
Byung Chul LEE
;
Ji Sung LEE
;
Yong Jin CHO
Author Information
- Publication Type:Original Article
- Keywords: weekend effect; weekend admission; ischemic stroke
- MeSH: Heart Diseases; Hospitalization; Humans; Neurology; Odds Ratio; Prospective Studies; Republic of Korea; Stroke
- From:Journal of Clinical Neurology 2012;8(4):265-270
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND PURPOSE: Stroke requires consistent care, but there is concern over the "weekend effect", whereby a weekend admission results in a poor outcome. Our aim was to determine the impact of weekend admission on clinical outcomes in patients with acute ischemic stroke in Korea. METHODS: The outcomes of patients admitted on weekdays and weekends were compared by analyzing data from a prospective outcome registry enrolling 1247 consecutive patients with acute ischemic stroke admitted to four neurology training hospitals in South Korea between September 2004 and August 2005. The primary outcome was a poor functional outcome at 3 months, defined as modified Rankin Scale (mRS) of 3-6. Secondary outcomes were 3-month mortality, use of thrombolysis, complication rate, and length of hospitalization. Shift analysis was also performed to compare overall mRS distributions. RESULTS: On weekends, 334 (26.8%) patients were admitted. Baseline characteristics were comparable between the weekday and weekend groups except for more history of heart disease and shorter admission time in weekend group. Univariate analysis revealed poor functional outcome at 3 months, 3-month mortality, complication rate, and length of hospitalization did not differ between the two groups. In addition, overall mRS distributions were comparable (p=0.865). After adjusting for baseline factors and stroke severity, weekend admission was not associated with poor functional outcome at 3 months (adjusted odds ratio, 1.05; 95% CI, 0.74-1.50). Furthermore, none of secondary endpoints differed between the two groups in multivariate analysis. CONCLUSIONS: Weekend admission was not associated with poor functional outcome than weekday admission in patients with acute ischemic stroke in this study. The putative weekend effect should be explored further by considering a wider range of hospital settings and hemorrhagic stroke.
