People admitted to the hospital on a weekend after a stroke are more likely to die compared to people admitted on a weekday, regardless of the severity of the stroke they experience, according to new research published in the Nov. 2, 2010, print issue of Neurology®, the medical journal of the American Academy of Neurology.
"We wanted to test whether the severity of strokes on weekends compared to weekdays would account for lower survival rates on the weekends," said Moira K. Kapral, MD, of the University of Toronto in Ontario, Canada. Kapral was with the Institute for Clinical Evaluative Sciences in Ontario when the research was done. "Our results suggest that stroke severity is not necessarily the reason for this discrepancy."
For the study, researchers analyzed five years of data from the Canadian Stroke Network on 20,657 patients with acute stroke from 11 stroke centers in Ontario. Only the first stroke a person experienced was included in the study.
People with moderate to severe stroke were just as likely to be admitted to the hospital on weekends and weekdays, but those with mild stroke were less likely to be admitted on weekends in the study. Those who were seen on weekends were slightly older, more likely to be taken by ambulance and experienced a shorter time from the onset of stroke symptoms to hospital arrival on average.
The study found that seven days after a stroke, people seen on weekends had an 8.1 percent risk of dying compared to a 7.0 percent risk of dying for those seen on weekdays. The results stayed the same regardless of age, gender, stroke severity, other medical conditions and the use of blood clot-busting medications.
"Stroke is not the only condition in which lower survival rates have been linked for people admitted to hospitals on the weekends. The reason for the differences in rates could be due to hospital staffing, limited access to specialists and procedures done outside of regular hours," said Kapral. "More research needs to be done on why the rates are different so that stroke victims can have the best possible chance of surviving."
There were no differences found in the quality of stroke care, including brain scans and admission time, between weekends and weekdays.
The study was supported by the Canadian Stroke Network.
- Jiming Fang, Gustavo Saposnik, Frank L. Silver, Moira K. Kapral, and for the Investigators of the Registry of the Canadian Stroke Network. Association between weekend hospital presentation and stroke fatality Neurology. Neurology, 2010; 75: 1589-1596 DOI: 10.1212/WNL.0b013e3181fb84bc
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