Canadian scientists have found that ischemic stroke sufferers are more likely to die within seven days of admission if they are admitted to hospital at the weekend than during the week.
However, they do not want this news to cause delayed admissions. Their message to patients, carers and health professionals is to get the stroke patient into an appropriate hospital as soon as possible since the race against time is the greatest priority.
The study is published in Stroke: Journal of the American Heart Association.
The research team was led by Dr Gustavo Saposnik assistant professor of medicine and director of the Stroke Research Unit Division of Neurology at the University of Toronto and also a staff neurologist at St. Michael’s Hospital in Toronto.
Dr Saposnik and colleagues looked at data from all ischemic stroke hospital admissions in Canada between April 2003 and March 2004. They took the data from the national Hospital Morbidity Database which includes sociodemographic, administrative, care and diagnostic data from all of Canada’s acute care centres, including rural and urban, teaching and non-teaching, small and large communities.
During the year, 26,676 patients were admitted to 606 hospitals with ischemic stroke. And of these, nearly 25 per cent were admitted on a Saturday or a Sunday.
There was a slight age and gender difference between the two groups. Patients admitted at the weekend were on average 75 years old and more likely to be male, while those admitted on a weekday were on average 74 years old.
When they took into account the effect of age, gender, and medical complications unrelated to the stroke condition, the scientists found that patients admitted on a Saturday or Sunday had a 14 per cent higher risk of dying within seven days than patients admitted on a weekday.
They also found the risk was different for different settings. For instance, admission to a rural as opposed to an urban hospital carried an even higher death risk from weekend admission and when the doctor in charge was a general practitioner and not a specialist.
Weekend death rates were also different for non-teaching hospitals and when patients spent time in the intensive care unit.
Patients admitted on a Saturday or Sunday were also less likely to be discharged to go home.
These factors appear to be unmodifiable contributors from the patient’s side said the research team. “This seems to be a ‘natural’ phenomenon in health care, even in Canada with universal, government-funded health insurance with no co-payments,” said Dr Saposnik.
Dr Saposnik and his team suggested that unequal distribution of expertise, resources and staff between weekday and weekend might be one explanation.
Ischemic stroke, which is the most common type of stroke, is when an artery in the brain or leading to it has a blood clot that stops blood getting to important brain cells.
Dr Saposnik and his team emphasized one message: “time is brain”, and the sooner the stroke sufferer gets the attention he or she needs the more likely they are to have a successful result, no matter what day of the week it is, where they live or what kind of hospital they go into.
Commenting on the study, Dr Larry Goldstein, chair of the Stroke Council of the American Heart Association, said, “Although the differences in weekend admission found in this study may be real, the potential benefits of obtaining early treatment would well outweigh the risk of waiting.”
“Patients developing symptoms of stroke such as abrupt difficulty speaking or understanding, weakness or numbness affecting an arm or leg, and unexplained difficulty walking or with coordination need to get to a hospital organized to provide stroke care as soon as possible, regardless of the day of the week,” he added.
While this study looked into the hospital side variables, the researchers also pointed out that certain patient side factors played a role, for example higher drug and alcohol consumption occurs at the weekend and this could also elevate death risk.
“Weekends: A Dangerous Time for Having a Stroke?”
Gustavo Saposnik, Akerke Baibergenova, Neville Bayer, and Vladimir Hachinski
Published online before print March 8, 2007
Stroke 2007, doi:10.1161/01.STR.0000259622.78616.ea
Written by: Catharine Paddock
Writer: Medical News Today