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Author Spotlight: Innovative Techniques and Future Directions in Stroke Research
Published on: May 5, 2023
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Academic year-end changeover and stroke outcomes
Tai Hwan Park1, Donald A Redelmeier2, Shudong Li3
1Department of Neurology, Seoul Medical Center, Seoul, Korea.
Summary
The "July effect" did not impact acute ischemic stroke patient outcomes, with similar 30-day mortality and functional status despite reduced thrombolysis and stroke unit care for July admissions.
Area of Science:
- Neurology
- Healthcare Quality
- Public Health
Background:
- The
- July effect" hypothesizes reduced quality of care and outcomes in teaching hospitals when new trainees begin in July.
- This study investigates the impact of July admissions on acute ischemic stroke (AIS) patients.
Purpose of the Study:
- To evaluate the association between July admission and patient outcomes for acute ischemic stroke (AIS).
- To assess the impact of the "July effect" on stroke care processes and patient outcomes in tertiary stroke centers.
Main Methods:
- Retrospective analysis of 10,319 AIS patients admitted to 11 Ontario stroke centers between July 2003 and March 2008.
- Comparison of outcomes (30-day mortality, functional outcome) and processes of care (thrombolysis, dysphagia screening, stroke unit care) between patients admitted in July and other months.
- Sensitivity analysis included both July and August to assess the
- July effect".
Main Results:
- No significant difference in baseline characteristics or stroke severity between July and non-July admissions.
- Patients admitted in July received less frequent thrombolysis (12% vs. 16%), dysphagia screening (64% vs. 68%), and stroke unit care (62% vs. 68%).
- July admission was not associated with increased 30-day mortality (aOR 0.88) or poor functional outcome (aOR 0.92).
Conclusions:
- Acute ischemic stroke patients admitted in July to tertiary stroke centers experienced similar outcomes compared to other months.
- Despite observed reductions in thrombolysis and stroke unit care, the
- July effect" did not negatively impact patient outcomes for AIS.
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