Weekend effect on 30-day mortality for ischemic and hemorrhagic stroke analyzed using severity index and staffing...

Area of Science:

• Neurology
• Public Health
• Health Services Research

Background:

• The weekend effect, where stroke outcomes vary by admission day, has inconsistent findings, particularly for ischemic stroke.
• Previous research often overlooked stroke severity and staffing levels as confounding factors.

Purpose of the Study:

• To investigate the weekend effect on 30-day mortality in both ischemic and hemorrhagic stroke patients.
• To account for confounding variables such as stroke severity and hospital staffing levels.

Main Methods:

• Retrospective analysis of 278,632 ischemic or hemorrhagic stroke patients from January 2015 to December 2018.
• Data sourced from the National Health Insurance System and Medical Resource Report.
• Primary outcome: 30-day all-cause mortality, analyzed using multi-level logistic regression.

Main Results:

• Weekend admissions were associated with higher 30-day mortality for both hemorrhagic (16.84% vs 15.55%) and ischemic stroke (5.06% vs 4.92%).
• After adjusting for confounding factors, the weekend effect remained significant for hemorrhagic stroke (OR 1.05, 95% CI 1.00-1.10).
• The association between weekend admission and mortality was not significant for ischemic stroke (OR 1.01, 95% CI 0.96-1.06).

Conclusions:

• Weekend admission for hemorrhagic stroke is linked to increased mortality, even after adjusting for confounders.
• Further research is needed to elucidate the specific factors contributing to higher weekend mortality in stroke patients.