Abstract 308: Ischemic Stroke and the Weekend Effect: A Population-Based Study
Objective: We assessed in-hospital mortality and utilization of invasive procedures following ischemic stork admissions on the weekend versus weekdays in the United States.
Background: stroke is a common condition requiring urgent diagnosis and intervention. Previous smaller studies show poor outcomes for time-sensitive medical conditions during weekend admissions, however whether these associations persist is not known.
Methods: We used the 2009 Nationwide Inpatient Sample to examine differences in all-cause in-hospital mortality between weekend versus weekday admitted patients with a principal diagnosis of ischemic stroke. Hierarchical analysis was used to identify if weekend admission was associated with decreased utilization of procedural intervention and increased subsequent complications as well.
Results: We identified 561,960stroke admissions of which 20.63% were weekend admissions. Adjusted mortality for the weekend admitted cohort was higher for weekend admissions [Odds Ratio (OR), 1.26; 95% Confidence Interval (CI) 1.17-1.37] and patients were significantly less likely to receive Endarterectomy or Thrombolytic therapy on their first day of admission [OR: 0.62, 95% CI: 0.60-0.64]. Further, for stoke patients admitted during the weekend who underwent procedural interventions, in-hospital mortality and complications were higher as compared to patients undergoing the same procedures on weekdays.
Conclusion: For stroke patients, weekend admission is associated with higher mortality and lower utilization of invasive procedures, and those who did undergo these interventions had higher rates of mortality and complications than their weekday counterparts. This is likely due to several factors and we speculate that access to diagnostic and interventional procedures maybe contingent on decreased staff and lower weekend coverage that may impact regular workflow.
Author Disclosures: M. Khoshchehreh: None. S. Malik: None.
- © 2014 by American Heart Association, Inc.