Is the weekend effect true in acute stroke patients at tertiary stroke center?

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http://hdl.handle.net/10138/334378

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Räty , S , Martinez-Majander , N , Suomalainen , O , Sibolt , G , Tiainen , M , Valkonen , K , Sairanen , T , Forss , N & Curtze , S 2021 , ' Is the weekend effect true in acute stroke patients at tertiary stroke center? ' , Journal of the Neurological Sciences , vol. 427 , 117557 . https://doi.org/10.1016/j.jns.2021.117557

Title: Is the weekend effect true in acute stroke patients at tertiary stroke center?
Author: Räty, Silja; Martinez-Majander, Nicolas; Suomalainen, Olli; Sibolt, Gerli; Tiainen, Marjaana; Valkonen, Kati; Sairanen, Tiina; Forss, Nina; Curtze, Sami
Contributor: University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
University of Helsinki, Doctoral Programme in Clinical Research
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
University of Helsinki, HUS Neurocenter
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2021-08-15
Language: eng
Number of pages: 6
Belongs to series: Journal of the Neurological Sciences
ISSN: 0022-510X
URI: http://hdl.handle.net/10138/334378
Abstract: Background: There is contradicting evidence on the outcome of emergency patients treated during weekends versus weekdays. We studied if outcome of ischemic stroke patients receiving intravenous thrombolysis (IVT) differs according to the treatment time. Methods: Our retrospective study included consecutive patients receiving IVT within 4.5 h of stroke onset between June 1995 and December 2018 at the Helsinki University Hospital. The patients were compared based on the treatment initiation either during weekdays (Monday to Friday) or weekend (Saturday and Sunday). The primary outcome was 3-month mortality and secondary outcomes comprised 3-month modified Rankin Scale (mRS) and incidence of symptomatic intracerebral hemorrhage (sICH). Additional analyses studied the effect of IVT treatment according to non-office hours, time of day, and season. Results: Of the 3980 IVT-treated patients, 28.0% received treatment during weekends. Mortality was similar after weekend (10.0%) and weekday (10.6%) admissions in the multivariable regression analysis (OR 0.78; 95% CI 0.59-1.03). Neither 3-month mRS (OR 0.98; 95% CI 0.86-1.12), nor the occurrence of sICH (4.2% vs 4.6%; OR 0.87; 95% CI 0.60-1.26) differed between the groups. No outcome difference was observed between the office vs non-office hours or by the time of day. However, odds for worse outcome were higher during autumn (OR 1.19; 95% CI 1.04-1.35) and winter (OR 1.15; 95% CI 1.01-1.30). Conclusion: We did not discover any weekend effect for IVT-treated stroke patients. This confirms that with standardized procedures, an equal quality of care can be provided to patients requiring urgent treatment irrespective of time.
Subject: Weekend effect
Thrombolysis
Ischaemic stroke
Circadian rhythm
Functional outcome
Mortality
ACUTE ISCHEMIC-STROKE
SEASONAL-VARIATION
CASE-FATALITY
THROMBOLYSIS
ADMISSION
CARE
MORTALITY
OUTCOMES
QUALITY
WEEKDAY
3112 Neurosciences
3124 Neurology and psychiatry
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