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More Aggressive Treatment for Weekend Stroke
Date:1/11/2010

Patients more apt to get a clot-dissolving drug than on weekdays, study found

MONDAY, Jan. 11 (HealthDay News) -- Stroke victims brought to a hospital on a weekend are more likely to receive the powerful clot-dissolving drug tPA than those who arrive on a weekday, a study finds.

It's an unexpected finding, since the study was triggered by a previous report showing that aggressive treatment for heart attacks was more likely to be given during the week rather than the weekend, noted study lead author Abby S. Kazley, assistant professor of health administration and policy at the Medical University of South Carolina.

The heart attack study sent Kazley and her colleagues searching through the records of almost 79,000 people admitted to Virginia hospitals between 1998 and 2006 with ischemic strokes, in which a clot blocks a brain blood vessel.

The research team found that relatively few patients received tissue plasminogen activator (tPA), which works quickly to break up clots. In fact, only 543 of the 58,378 people admitted on weekdays got the drug, compared to 229 of the 20,279 admitted on weekends. The numbers show that the weekend stroke victims were 20 percent more likely to be given tPA than weekday arrivals.

"That seemed counterintuitive, but the more we considered it the more likely it appeared to be the case," Kazley said. Her team published the findings in the January issue of the Archives of Neurology.

During the week, neurologists are more likely to be involved with routine procedures, she noted. "Because there are fewer such elective procedures on weekends, patients have better access to expertise and better access to diagnostic technology such as CT [computed tomography] scanners," Kazley reasoned. "They are also more likely to present at an earlier time, since they are less likely to have to battle traffic to get to the hospital."

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