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Updated: May 16, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Comprehensive stroke centers and the 'weekend effect': the SPOTRIAS experience
Karen C Albright1, Sean I Savitz, Rema Raman
1Health Services and Center for Outcome and Effectiveness Research and Education, University of Alabama at Birmingham, Birmingham, AL 35249-3280, USA. kca@uab.edu
Cerebrovascular Diseases (Basel, Switzerland)
|December 5, 2012
Summary
Weekend admission did not worsen outcomes for ischemic stroke patients in a large comprehensive stroke center. This suggests organized stroke care, not admission timing, is key for better patient results.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Public Health
Background:
- Previous research indicated higher mortality for ischemic stroke patients admitted on weekends.
- A potential 'weekend effect' in stroke care outcomes has been a subject of concern.
Purpose of the Study:
- To investigate if weekend admission is linked to poorer outcomes in ischemic stroke patients.
- To evaluate the 'weekend effect' in a large cohort from a comprehensive stroke center (CSC).
Main Methods:
- Retrospective analysis of consecutive ischemic stroke patients admitted within 6 hours of symptom onset.
- Exclusion of patients receiving intra-arterial therapy or in non-observational trials.
- Comparison of outcomes between weekday and weekend admissions using multivariate logistic regression, adjusting for age, NIHSS, and glucose levels.
Main Results:
- No significant difference in tissue plasminogen activator treatment rates between weekday and weekend admissions.
- Weekend admission was not a significant predictor of in-hospital mortality, length of stay, or discharge disposition.
- No significant differences observed in favorable functional outcomes at discharge or 90-day mortality between the groups.
Conclusions:
- The 'weekend effect' was not observed in this large cohort of ischemic stroke patients treated at comprehensive stroke centers.
- Access to 24/7 stroke specialists and organized stroke care systems likely mitigate the 'weekend effect'.
- Findings suggest re-evaluating EMS protocols for preferential weekend stroke patient transport to comprehensive stroke centers.
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