Canadian research shows that stroke patients are among those whose chances of dying in hospital are higher if they are admitted on a weekend — a phenomenon dubbed the “weekend effect.”
“It’s relatively common for different conditions — most commonly conditions that require surgical intervention,” lead study author Dr. Gustavo Saposnik says of the weekend effect. “For medical conditions which require specifically medical management, it hasn’t been extensively studied.”
Saposnik, director of stroke research at St. Michael’s Hospital in Toronto, used a national database to study information on people admitted to hospital for an ischemic stroke, in which the brain’s blood supply is interrupted by a blood clot. An ischemic stroke is treated with medication, whereas the less common hemorrhagic stroke, which involves bleeding in the brain, is more likely to require surgery.
The study involved more than 26,000 hospital admissions for ischemic stroke from April 2003 to March 2004, one-quarter of which occurred on weekends.
“Patients who were admitted at weekends were more likely to die,” Saposnik says. “We also found that patients admitted on weekends due to an ischemic stroke were less likely to be discharged home. So basically it means the outcome was poorer in those patients admitted on weekends.”
Overall, 8.5 per cent of patients admitted on weekends died within seven days, compared with 7.4 per cent of those admitted on weekdays. And 44.8 per cent of weekend patients were discharged home, versus 48.7 per cent of weekday patients.
The disparity was more striking in rural hospitals. In these facilities, the stroke mortality rate was 26 per cent higher for weekend patients than for weekday patients, compared with a gap of only 14 per cent for urban hospitals.
But Saposnik stresses that people who think they may be having a stroke should get to hospital right away, regardless of the day of the week.