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Mortality rates higher for patients with stroke admitted on weekends
McKinney J. Stroke. 2011;doi:10.1161/STROKEAHA.110.612317.
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Patients with stroke had a significantly higher risk for death by 90 days when admitted to New Jersey hospitals during the weekend vs. being admitted during the weekday, according to a study.
Using data collected between 1996 and 2007, researchers used the MI Data Acquisition System to view information on 134,441 patients admitted to 88 New Jersey primary stroke centers, comprehensive stroke centers and nonstroke centers with a primary diagnosis of cerebral infarction. According to the study, “the primary outcome measure was 90 day all-cause mortality after hospital admission,” but researchers also included in-hospital and cumulative death rates at 30, 90 and 365 days. Any out-of-hospital deaths were found by matching the system records with New Jersey death registration files.
Weekend (Saturday, Sunday and holidays) vs. weekday admissions was the primary independent variable for both in-hospital and cumulative all-cause mortality. Differences in mortality between weekend and weekday admissions over time were examined, as well as whether these differences could be “explained by differences in stroke care temporarily by year of admission or operationally by stroke center certification.”
Of patients admitted to hospitals, 23.4% were admitted to comprehensive stroke centers, 51.5% to primary stroke centers and 25.1% to nonstroke centers. On weekends, patients with stroke were more likely to be admitted through the ED and to comprehensive stroke centers. According to researchers, 90-day mortality for patients with cerebral infarction during the study was 16.7%, and in-hospital and 30-day mortality also increased for patients admitted on weekends. Researchers found that IV thrombolysis rates were higher for patients admitted on the weekend with stroke. Treatment with IV tissue-type plasminogen activator also remained higher and increased at comprehensive stroke centers and primary stroke centers.
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