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Specialized Stroke Centers Deliver on the Weekends
Date:8/25/2011

he researchers found that the death rate 90 days after patients were treated for stroke over the weekend was 17.2 percent, compared with 16.5 percent for weekday admissions. But after adjusting for factors such as other medical conditions, the "weekend effect" raised the death rate to a 5 percent difference between the two groups.

This problem appeared to be largely due to a decrease in hospital staff and critical services on the weekend, McKinney said. "Fewer technicians are there, attending physicians may pop in and pop out, so a lot of hospitals are running on a kind of skeleton crew on the weekend, compared with weekdays," he said.

But no increase in 90-day mortality linked to weekend visits was seen in patients treated at the comprehensive stroke centers.

Dr. Gregg Fonarow, chairman of the American Heart Association's Hospital Accreditation Science Committee and professor of cardiovascular medicine of the University of California, Los Angeles, said that "admission to the hospital during weekends is associated with increased mortality in many, but not all, acute medical conditions."

Heart attack, stroke, blood clot and intensive care unit admissions, among others, during weekends have all been linked with increased in-hospital or short-term mortality compared with weekdays, he said.

"Reduced staffing and physician coverage, decreased use of invasive therapies, and differences in patient characteristics may, in part, explain the discrepancy in outcomes between weekend and weekday hospital admissions," Fonarow said.

Greater hospital staffing for critical services, specialty stroke services and hospital participation in systems of care, such as the American Stroke Association's "Get With the Guidelines - Stroke Program, "may help to ameliorate the weekend effect and be lifesaving," he added.

Another stroke expert, Dr. Ralph Sacco, president of the American Heart Association/American Stroke Association, said that "the stud
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