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Hospital care for patients experiencing weekend vs weekday stroke: a comparison of quality and aggressiveness of care.
Arch Neurol. 2010 Jan; 67(1):39-44.AN

Abstract

BACKGROUND

We examined the quality and aggressiveness of care for the treatment of acute ischemic stroke (AIS) on weekends vs weekdays. Acute ischemic stroke is a leading cause of death and disability in the United States, and aggressive treatment must be provided within 3 hours for optimal patient outcomes. Because of this short treatment window for the administration of tissue plasminogen activator, patients need around-the-clock access to high-quality and aggressive care.

OBJECTIVE

To determine whether there is a difference in the quality or aggressiveness of care for patients experiencing AIS on weekends vs weekdays.

DESIGN

Retrospective study.

SETTING

Academic research. Patients We conducted a retrospective study of patients with AIS in Virginia. Two logistic regression analyses assessed the relationship between weekend admission and quality and aggressiveness of care, while controlling for appropriate patient-level and hospital-level control variables. A propensity score stratification approach controlled for selection bias.

MAIN OUTCOME MEASURES

Treatment with tissue plasminogen activator and in-hospital mortality.

RESULTS

Patients with AIS admitted on weekends are more likely to receive tissue plasminogen activator than those admitted on weekdays (P < .05). No statistically significant difference was noted in patient mortality based on day of admission (P >or= .05). We detected no difference in the likelihood to seek hospital care on weekends between patients with AIS vs patients with hemorrhagic stroke.

CONCLUSIONS

Patients experiencing AIS are more likely to receive tissue plasminogen activator on weekends than on weekdays. Patients experiencing AIS who are admitted on weekends are no more likely to die than those who are admitted on weekdays. Further research is necessary to understand differences in weekend vs weekday care.

Authors+Show Affiliations

Department of Health Professions, Medical University of South Carolina, 151 Rutledge Ave, Charleston, SC 29425, USA. swansoaj@musc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20065127

Citation

Kazley, Abby S., et al. "Hospital Care for Patients Experiencing Weekend Vs Weekday Stroke: a Comparison of Quality and Aggressiveness of Care." Archives of Neurology, vol. 67, no. 1, 2010, pp. 39-44.
Kazley AS, Hillman DG, Johnston KC, et al. Hospital care for patients experiencing weekend vs weekday stroke: a comparison of quality and aggressiveness of care. Arch Neurol. 2010;67(1):39-44.
Kazley, A. S., Hillman, D. G., Johnston, K. C., & Simpson, K. N. (2010). Hospital care for patients experiencing weekend vs weekday stroke: a comparison of quality and aggressiveness of care. Archives of Neurology, 67(1), 39-44. https://doi.org/10.1001/archneurol.2009.286
Kazley AS, et al. Hospital Care for Patients Experiencing Weekend Vs Weekday Stroke: a Comparison of Quality and Aggressiveness of Care. Arch Neurol. 2010;67(1):39-44. PubMed PMID: 20065127.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospital care for patients experiencing weekend vs weekday stroke: a comparison of quality and aggressiveness of care. AU - Kazley,Abby S, AU - Hillman,Diane Gartner, AU - Johnston,Karen C, AU - Simpson,Kit N, PY - 2010/1/13/entrez PY - 2010/1/13/pubmed PY - 2010/2/13/medline SP - 39 EP - 44 JF - Archives of neurology JO - Arch Neurol VL - 67 IS - 1 N2 - BACKGROUND: We examined the quality and aggressiveness of care for the treatment of acute ischemic stroke (AIS) on weekends vs weekdays. Acute ischemic stroke is a leading cause of death and disability in the United States, and aggressive treatment must be provided within 3 hours for optimal patient outcomes. Because of this short treatment window for the administration of tissue plasminogen activator, patients need around-the-clock access to high-quality and aggressive care. OBJECTIVE: To determine whether there is a difference in the quality or aggressiveness of care for patients experiencing AIS on weekends vs weekdays. DESIGN: Retrospective study. SETTING: Academic research. Patients We conducted a retrospective study of patients with AIS in Virginia. Two logistic regression analyses assessed the relationship between weekend admission and quality and aggressiveness of care, while controlling for appropriate patient-level and hospital-level control variables. A propensity score stratification approach controlled for selection bias. MAIN OUTCOME MEASURES: Treatment with tissue plasminogen activator and in-hospital mortality. RESULTS: Patients with AIS admitted on weekends are more likely to receive tissue plasminogen activator than those admitted on weekdays (P < .05). No statistically significant difference was noted in patient mortality based on day of admission (P >or= .05). We detected no difference in the likelihood to seek hospital care on weekends between patients with AIS vs patients with hemorrhagic stroke. CONCLUSIONS: Patients experiencing AIS are more likely to receive tissue plasminogen activator on weekends than on weekdays. Patients experiencing AIS who are admitted on weekends are no more likely to die than those who are admitted on weekdays. Further research is necessary to understand differences in weekend vs weekday care. SN - 1538-3687 UR - https://www.unboundmedicine.com/medline/citation/20065127/Hospital_care_for_patients_experiencing_weekend_vs_weekday_stroke:_a_comparison_of_quality_and_aggressiveness_of_care_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneurol.2009.286 DB - PRIME DP - Unbound Medicine ER -