Abstract
Aims
The aim of this study was to investigate whether stratifying patients according to the time period from admission to the start of regular working hours would help detect a weekend effect in acute stroke patients.
Methods
Ischemic stroke patients admitted between October 2002 and March 2012 were analyzed. Working hours were defined as 9:00–17:00 on weekdays. Patients were divided into those admitted during working hours (no-wait group) and three other groups according to the time from admission to working hours: ⩽24 h (short-wait group), 24–48 h (medium-wait group), and >48 h (long-wait group). The modified Rankin Scale score and mortality at three-months were compared among the groups.
Results
Of 5625 patients, 3323 (59%) were admitted outside working hours. The proportion of patients with an mRS score 0–1 at three-months showed a decreasing trend with the time period before working hours: 47% (no-wait group), 42% (short-wait group), 42% (medium-wait group), and 38% (long-wait group), respectively (P < 0·001). When the no-wait group was used as a reference, the odds ratio for modified Rankin Scale score 0–1 was 0·88 (95% confidence interval, 0·75–1·04) in the short-wait group, 0·86 (0·69–1·07) in the medium-wait group, and 0·67 (0·53–0·85) in the long-wait group after adjusting for sex, age, premorbid mRS score, previous morbidity, stroke severity, and vascular risk factors. Mortality at three-months was not different between the no-wait group and the other groups.
Conclusion
A weekend effect might be evident if patients were stratified according to the time period from admission until working hours.
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