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Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission
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. MET...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Neurological Association
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540285/ https://www.ncbi.nlm.nih.gov/pubmed/23323134 http://dx.doi.org/10.3988/jcn.2012.8.4.265 |
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author | Kim, Sang-Chul Hong, Keun-Sik Hwang, Seon-Il Kim, Ji-Eun Kim, Ah-Ro Cho, Joong-Yang Park, Hee Kyung Park, Ji-Hyun Koo, Ja-Seong Park, Jong-Moo Bae, Hee-Joon Han, Moon-Ku Kang, Dong-Wha Oh, Mi-Sun Yu, Kyung-Ho Lee, Byung-Chul Lee, Ji-Sung Cho, Yong-Jin |
author_facet | Kim, Sang-Chul Hong, Keun-Sik Hwang, Seon-Il Kim, Ji-Eun Kim, Ah-Ro Cho, Joong-Yang Park, Hee Kyung Park, Ji-Hyun Koo, Ja-Seong Park, Jong-Moo Bae, Hee-Joon Han, Moon-Ku Kang, Dong-Wha Oh, Mi-Sun Yu, Kyung-Ho Lee, Byung-Chul Lee, Ji-Sung Cho, Yong-Jin |
author_sort | Kim, Sang-Chul |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-3540285 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Korean Neurological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-35402852013-01-15 Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission Kim, Sang-Chul Hong, Keun-Sik Hwang, Seon-Il Kim, Ji-Eun Kim, Ah-Ro Cho, Joong-Yang Park, Hee Kyung Park, Ji-Hyun Koo, Ja-Seong Park, Jong-Moo Bae, Hee-Joon Han, Moon-Ku Kang, Dong-Wha Oh, Mi-Sun Yu, Kyung-Ho Lee, Byung-Chul Lee, Ji-Sung Cho, Yong-Jin J Clin Neurol Original Article 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. Korean Neurological Association 2012-12 2012-12-21 /pmc/articles/PMC3540285/ /pubmed/23323134 http://dx.doi.org/10.3988/jcn.2012.8.4.265 Text en Copyright © 2012 Korean Neurological Association http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Sang-Chul Hong, Keun-Sik Hwang, Seon-Il Kim, Ji-Eun Kim, Ah-Ro Cho, Joong-Yang Park, Hee Kyung Park, Ji-Hyun Koo, Ja-Seong Park, Jong-Moo Bae, Hee-Joon Han, Moon-Ku Kang, Dong-Wha Oh, Mi-Sun Yu, Kyung-Ho Lee, Byung-Chul Lee, Ji-Sung Cho, Yong-Jin Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission |
title | Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission |
title_full | Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission |
title_fullStr | Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission |
title_full_unstemmed | Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission |
title_short | Weekend Admission in Patients with Acute Ischemic Stroke Is Not Associated with Poor Functional Outcome than Weekday Admission |
title_sort | weekend admission in patients with acute ischemic stroke is not associated with poor functional outcome than weekday admission |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540285/ https://www.ncbi.nlm.nih.gov/pubmed/23323134 http://dx.doi.org/10.3988/jcn.2012.8.4.265 |
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