open access

Vol 46, No 1 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2010-12-31
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Weekend versus weekday admissions in Polish stroke centres – could admission day affect prognosis in Polish ischaemic stroke patients?

Maciej Niewada, Agnieszka Jezierska-Ostapczuk, Marta Skowrońska, Iwona Sarzyńska-Długosz, Anna Członkowska
DOI: 10.5114/ninp.2012.27209
·
Neurol Neurochir Pol 2012;46(1):15-21.

open access

Vol 46, No 1 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2010-12-31

Abstract

Background and purpose

Disparities in resources, access to the expertise and healthcare providers both at hospital and before admission, or patients’ awareness of stroke symptoms can cause differences in weekend and weekday stroke severity and prognosis. The aim of the study was to explore differences in baseline characteristics and outcomes of ischaemic stroke patients admitted on weekdays and weekends.

Material and methods

A questionnaire based on the WHO Step Stroke and Swedish Stroke Registry was used to collect data on patients admitted to centres participating in the POLKARD Hospital Stroke Registry between June 1st, 2004 and May 31st, 2005. To ensure the quality, only centres reporting at least 100 patients were analysed. Clinical characteristics and early outcomes (death rate and poor outcome defined as modified Rankin scale score of 3 or above) were compared between patients admitted on weekdays and weekends.

Results

A total of 19667 ischaemic stroke patients, including 5924 admitted during weekends, were reported by 72 stroke centres. Weekend patients were older, more often disabled prior to stroke and more commonly presented with atrial fibrillation and coronary heart disease. Weekend patients were more likely to present consciousness disturbances at admission. More patients admitted on weekends died during hospitalization or had poor outcome at discharge than weekday patients (15.9% and 59.8% vs. 14.1% and 55.3%, respectively). After adjusting for baseline severity of stroke and case-mix, the regression model showed that weekend ischaemic stroke patients had worse prognosis (odds of 1.137 and 1.147 for death and poor outcome, respectively).

Conclusions

Admissions on weekends are associated with higher mortality and poor outcome, and that can be only partially explained by differences in baseline characteristics of admitted patients.

Abstract

Background and purpose

Disparities in resources, access to the expertise and healthcare providers both at hospital and before admission, or patients’ awareness of stroke symptoms can cause differences in weekend and weekday stroke severity and prognosis. The aim of the study was to explore differences in baseline characteristics and outcomes of ischaemic stroke patients admitted on weekdays and weekends.

Material and methods

A questionnaire based on the WHO Step Stroke and Swedish Stroke Registry was used to collect data on patients admitted to centres participating in the POLKARD Hospital Stroke Registry between June 1st, 2004 and May 31st, 2005. To ensure the quality, only centres reporting at least 100 patients were analysed. Clinical characteristics and early outcomes (death rate and poor outcome defined as modified Rankin scale score of 3 or above) were compared between patients admitted on weekdays and weekends.

Results

A total of 19667 ischaemic stroke patients, including 5924 admitted during weekends, were reported by 72 stroke centres. Weekend patients were older, more often disabled prior to stroke and more commonly presented with atrial fibrillation and coronary heart disease. Weekend patients were more likely to present consciousness disturbances at admission. More patients admitted on weekends died during hospitalization or had poor outcome at discharge than weekday patients (15.9% and 59.8% vs. 14.1% and 55.3%, respectively). After adjusting for baseline severity of stroke and case-mix, the regression model showed that weekend ischaemic stroke patients had worse prognosis (odds of 1.137 and 1.147 for death and poor outcome, respectively).

Conclusions

Admissions on weekends are associated with higher mortality and poor outcome, and that can be only partially explained by differences in baseline characteristics of admitted patients.

Get Citation

Keywords

day of the week, early outcome, fatality, stroke, weekend

About this article
Title

Weekend versus weekday admissions in Polish stroke centres – could admission day affect prognosis in Polish ischaemic stroke patients?

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 46, No 1 (2012)

Pages

15-21

DOI

10.5114/ninp.2012.27209

Bibliographic record

Neurol Neurochir Pol 2012;46(1):15-21.

Keywords

day of the week
early outcome
fatality
stroke
weekend

Authors

Maciej Niewada
Agnieszka Jezierska-Ostapczuk
Marta Skowrońska
Iwona Sarzyńska-Długosz
Anna Członkowska

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