TY - JOUR
T1 - Clinical outcomes after thrombectomy for acute ischemic stroke on weekends versus weekdays
AU - Saad, Ali
AU - Adil, Malik Muhammad
AU - Patel, Vikas
AU - Owada, Kumiko
AU - Winningham, Melanie J.
AU - Nahab, Fadi
N1 - Publisher Copyright:
© 2014 by National Stroke Association.
PY - 2014
Y1 - 2014
N2 - Background: The objective of this study was to determine whether clinical outcomes differed in acute ischemic stroke (AIS) patients who underwent thrombectomy on weekends versus weekdays. Methods: Patients with a primary diagnosis of AIS who underwent thrombectomy were identified from the Nationwide Inpatient Sample from 2005 to 2011 and stratified according to weekend or weekday admission. Logistic regression analysis was performed to identify factors associated with moderate-to-severe disability at hospital discharge in teaching and nonteaching hospitals. Results: Of 12,055 patients with AIS who underwent thrombectomy during the study period, 2862 (23.7%)were admitted on a weekend. In a multivariate logistic regression analysis, factors associated withmoderate or severe disability at discharge in nonteaching hospitals were weekend admission (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.0-2.8; P = .04), diagnosis of hypertension (OR, 1.9; 95% CI, 1.0-3.6; P = .05), and Medicare or Medicaid insurance status (OR, 2.1; 95% CI 1.1- 4.3; P = .02); factors associated with moderate or severe disability at discharge in teaching hospitals were age > 70 years (OR, 1.5; 95% CI, 1.1-2.2; P =.02), pneumonia (OR, 4.7; 95% CI, 2.2-10.2; P < 0001), sepsis (OR, 8.2; 95% CI, 1.2-54.8; P =.03), intracranial hemorrhage (OR, 3.3; 95% CI, 1.8-6.1; P =.0001), and treatment in a Northwest hospital region (OR, 1.7; 95% CI, 1.2-2.4; P = .03). Conclusions: AIS patients undergoing thrombectomy who were admitted to nonteaching hospitals on weekendsweremore likely to be dischargedwithmoderate-to-severe disability than those admitted onweekdays. No weekend effect on discharge clinical outcome was seen in teaching hospitals.
AB - Background: The objective of this study was to determine whether clinical outcomes differed in acute ischemic stroke (AIS) patients who underwent thrombectomy on weekends versus weekdays. Methods: Patients with a primary diagnosis of AIS who underwent thrombectomy were identified from the Nationwide Inpatient Sample from 2005 to 2011 and stratified according to weekend or weekday admission. Logistic regression analysis was performed to identify factors associated with moderate-to-severe disability at hospital discharge in teaching and nonteaching hospitals. Results: Of 12,055 patients with AIS who underwent thrombectomy during the study period, 2862 (23.7%)were admitted on a weekend. In a multivariate logistic regression analysis, factors associated withmoderate or severe disability at discharge in nonteaching hospitals were weekend admission (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.0-2.8; P = .04), diagnosis of hypertension (OR, 1.9; 95% CI, 1.0-3.6; P = .05), and Medicare or Medicaid insurance status (OR, 2.1; 95% CI 1.1- 4.3; P = .02); factors associated with moderate or severe disability at discharge in teaching hospitals were age > 70 years (OR, 1.5; 95% CI, 1.1-2.2; P =.02), pneumonia (OR, 4.7; 95% CI, 2.2-10.2; P < 0001), sepsis (OR, 8.2; 95% CI, 1.2-54.8; P =.03), intracranial hemorrhage (OR, 3.3; 95% CI, 1.8-6.1; P =.0001), and treatment in a Northwest hospital region (OR, 1.7; 95% CI, 1.2-2.4; P = .03). Conclusions: AIS patients undergoing thrombectomy who were admitted to nonteaching hospitals on weekendsweremore likely to be dischargedwithmoderate-to-severe disability than those admitted onweekdays. No weekend effect on discharge clinical outcome was seen in teaching hospitals.
KW - All cerebrovascular disease/stroke
KW - Endovascular therapy
KW - Harm/risk analysis
KW - Infarction
KW - Thrombectomy
KW - Weekend effect
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U2 - 10.1016/j.jstrokecerebrovasdis.2014.06.006
DO - 10.1016/j.jstrokecerebrovasdis.2014.06.006
M3 - Article
C2 - 25440362
AN - SCOPUS:84923252885
SN - 1052-3057
VL - 23
SP - 2708
EP - 2713
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 10
ER -