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학술저널
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대한신경과학회 Journal of Clinical Neurology Journal of Clinical Neurology 제8권 제4호
발행연도
2012.1
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265 - 270 (6page)

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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.
#weekend effect #weekend admission #ischemic stroke.

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참고문헌 (15)

참고문헌 신청
Albright KC / 2009 / Can comprehensive stroke centers erase the ‘weekend effect’? / Cerebrovasc Dis 27 : 107 ~ 113 google schola Angus DC / 2006 / Critical care delivery in the United States: distribution of services and compliance with Leapfrog recommendations / Crit Care Med 34 : 1016 ~ 1024 google schola Ensminger SA / 2004 / The hospital mortality of patients admitted to the ICU on weekends / Chest 126 : 1292 ~ 1298 google schola Fang J / 2010 / Investigators of the Registry of the Canadian Stroke Network. Association between weekend hospital presentation and stroke fatality / Neurology 75 : 1589 ~ 1 google schola Hasegawa Y / 2005 / The effect of weekends and holidays on stroke outcome in acute stroke units / Cerebrovasc Dis 20 : 325 ~ 331 google schola

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