Related Experiment Video
Updated: May 12, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Stroke care organization overcomes the deleterious 'weekend effect' on 1-month stroke mortality: a population-based
Y Béjot1, C Aboa-Eboulé, A Jacquin
1Dijon Stroke Registry, Department of Neurology, University Hospital and Medical School of Dijon, University of Burgundy, Burgundy, France. ybejot@yahoo.fr
Background And Purpose:
Suffering a stroke during the weekend is associated with a poorer prognosis. The impact of implementing a dedicated stroke care network in Dijon, France, in 2003 on 30-day mortality in strokes/transient ischaemic attacks (TIA) occurring during weekends/bank holidays was evaluated.
Methods:
All cases of stroke and TIA from 1985 to 2010 were identified from a population-based registry, using multiple overlapping sources of information. Demographics and clinical data were recorded. Cox regression models were used to evaluate associations between day of onset (weekdays versus weekends/bank holidays) and 30-day all-cause mortality. Data were stratified according to time periods [before (1985-2003) and after (2004-2010) implementation of the stroke network] and stroke subtypes (ischaemic stroke and intracerebral hemorrhage).
Results:
Of the 5864 recorded patients, 1465 (25%) had their event during weekends/bank holidays. Patients with stroke/TIA during weekdays were comparable with those with stroke/TIA during weekends/bank holidays for baseline characteristics. Excess mortality was observed in patients with stroke/TIA during weekends/bank holidays during 1985-2003 (18.2% vs. 14.0%, P < 0.01) but not during 2004-2010 (8.4% vs. 8.3%, P = 0.74). Onset during weekends/bank holidays was associated with a higher risk of 30-day mortality during 1985-2003 (adjusted hazard ratio 1.26; 95% CI 1.06-1.51, P = 0.01), but not during 2004-2010 (adjusted hazard ratio 0.99; 95% CI 0.69-1.43, P = 0.97).
Conclusion:
The deleterious effect of weekends/bank holidays on early stroke mortality disappeared after the organization of a dedicated stroke care network in our community. Our findings provide strong support for the implementation of quality improvement initiatives in order to attenuate inequalities in the management of stroke patients.
Related Concept Videos
Ischemic Stroke l: Introduction
Ischemic Stroke ll: Pathophysiology
Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Hemorrhagic Stroke l: Introduction
Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
