The influence of the day of the week of hospital admission on the prognosis of stroke patients

Barros, Juliana B.; Goulart, Alessandra Carvalho; Alencar, Airlane Pereira; Lotufo, Paulo A.

doi:10.1590/s0102-311x2013000400014

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…A “weekend effect” in patients with cerebrovascular disease is reported with heterogeneous results. 8 –16 A study utilized the Nationwide Inpatient Sample (NIS) from 2004 and showed 12% increased risk of death with weekend admissions. 13 A second study using data from Get With the Guidelines—Stroke program also demonstrated 19% increased mortality in weekend admissions among patients with hemorrhagic stroke.…”

Section: Introductionmentioning

confidence: 99%

A Nationwide Analysis of Outcomes of Weekend Admissions for Intracerebral Hemorrhage Shows Disparities Based on Hospital Teaching Status

Patel

Mahajan

Benjo

et al. 2015

The Neurohospitalist

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Background and Purpose: With the ''weekend effect'' being well described, the Brain Attack Coalition released a set of ''best practice'' guidelines in 2005, with the goal to uniformly provide standard of care to patients with stroke. We attempted to define a ''weekend effect'' in outcomes among patients with intracranial hemorrhage (ICH) over the last decade, utilizing the Nationwide Inpatient Sample (NIS) data. We also attempted to analyze the trend of such an effect. Materials and Methods: We determined the association of ICH weekend admissions with hospital outcomes including mortality, adverse discharge, length of stay, and cost compared to weekday admissions using multivariable logistic regression. We extracted our study cohort from the NIS, the largest all-payer data set in the United States. Results: Of 485 329 ICH admissions from 2002 to 2011, 27.5% were weekend admissions. Overall, weekend admissions were associated with 11% higher odds of in-hospital mortality. When analyzed in 3-year groups, excess mortality of weekend admissions showed temporal decline. There was higher mortality with weekend admissions in nonteaching hospitals persisted (odds ratios 1.16, 1.13, and 1.09, respectively, for 3-year subgroups). Patients admitted during weekends were also 9% more likely to have an adverse discharge (odds ratio 1.09; 95% confidence interval: 1.07-1.11; P < .001) with no variation by hospital status. There was no effect of a weekend admission on either length of stay or cost of care. Conclusion: Nontraumatic ICH admissions on weekends have higher in-hospital mortality and adverse discharge. This demonstrates need for in-depth review for elucidating this discrepancy and stricter adherence to standard-of-care guidelines to ensure uniform care.

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Section: Introductionmentioning

confidence: 99%

A Nationwide Analysis of Outcomes of Weekend Admissions for Intracerebral Hemorrhage Shows Disparities Based on Hospital Teaching Status

Patel

Mahajan

Benjo

et al. 2015

The Neurohospitalist

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“…This cohort was the first one to demonstrate the prognosis value of multimorbidity using CCI in long-term survival in a stroke cohort in Latin America. EMMA study is an ongoing stroke cohort, which demonstrated several stroke outcomes mentioned in previous publications in the last decade [10,23,29,30,31,32]. The study population in EMMA comes from a low-income area with poor public health support in the city of São Paulo located in Brazil.…”

Section: Discussionmentioning

confidence: 99%

Multimorbidities Are Associated to Lower Survival in Ischaemic Stroke: Results from a Brazilian Stroke Cohort (EMMA Study)

Castro¹,

Alencar²,

Benseñor³

et al. 2017

Cerebrovasc Dis

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Background: Stroke prognosis is related to the multimorbidity profile. Moreover, performing an individual evaluation of most common cerebrovascular risk factors (CVRF) not always identifies patients with poor prognosis. Thus, we decided to evaluate multimorbidity profile, focusing on the Charlson Comorbidity Index (CCI) validated by Goldstein for ischaemic stroke (IS) patients, a score that measures a burden of comorbidities and its related mortality in the long-term survival of the EMMA Study (Study of Stroke Mortality and Morbidity). Methods: Nine hundred fifty-nine individuals (median age 70 years) had validated data on the diagnosis of IS, main CVRF and clinical comorbidities pre index event such as atrial fibrillation (AF), stroke recurrence, diabetes, hypertension, heart failure and cancer. CCI modified by Goldstein was calculated, which includes 17 clinical conditions with scores ranging from 1 to 6 (0-31 points). Survival analyses were performed by Kaplan-Meier curves and Cox logistic regression models (cumulative hazard ratio [HR] with [95% CI]) for all-cause mortality at 180 days, and every 3 years up to 9-year follow-up. Mortality analyzes were performed by CCI categorized according to weight added to comorbidities (Reference group: zero, moderate: 1, severe: 2 and very severe: ≥3 points). We also tested the modification effect of AF and stroke recurrence including these conditions in the CCI. Results: The overall survival rate was 47% (508 deaths/959). The worst survival (577, 95% CI 381-773 days) and the highest risk of death after stroke were observed in the very severe CCI group (HR 3.18; 95% CI 2.16-4.69) up to 9 years. The inclusion of previous AF and stroke in the CCI slightly increased the risk of death for very severe CCI (HR 3.27; 95% CI 2.07-5.18). Conclusions: A high burden of comorbidities represented an independent predictor of poor prognosis increasing the risk of dying by 2 to 3 times among IS up to 9 years in the EMMA study. The inclusion of other CVRF such as AF and stroke recurrence slightly modified all-cause mortality risk.

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Analysis of Records of Patients with Cerebral Stroke Accident and its Correlations with Predisponent Factors

2023

IJCCD

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The Vascular cerebral Accident (VCA) is from a dysfunction in the blood vessel in a particular locus of the brain. In the injury, it is popularly known as “stroke” or “thrombosis”, which is a silent pathology mediated by actions considered modifiable and non-modifiable, causing reversible and/or permanent injuries respectively. Stroke can be subdivided into: ischemic stroke triggered by a blockage in the cerebral vascularization decreasing or stopping the supply of oxygen in the brain and the hemorrhagic stroke induced by a vascular rupture resulting in extravasation of blood inside the skull, trauma can lead to injury due to blood pressure. The objective of the essay is to evaluate medical records of patients who were hospitalized at a Hospital of Paraíba in the year 2016, aiming to highlight the main causes and consequences through anamnesis of it. The research is a documentary and exploratory study, athwart a pre-elaborated research instrument. The results were introduced through tables, obtained in Statistical Package for Social Sciences (SPSS), Version 22.0, based on the comparison of some variables such as gender, age, history of current pathology and others, correlated to the diagnostic hypothesis of AVC and AVE . In the results and conclusion of this essay it is possible to perceive that the greater the age, the greater the number of cases of Cerebral stroke and Encephalic stroke, decreasing in the extremes of age, being that still high the prevalence of death by this disease , especially by Encephalic stroke. Regarding the previous history, hypertension is one of the main factors associated with the occurrence of Cerebral Stroke and Encephalic Stroke, where in the current history hypertension, smoking and headache are responsible for most cases of stroke and stroke in individuals, and hemiparesis is the skeletal muscle factor that is most associated with pathology.

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The influence of the day of the week of hospital admission on the prognosis of stroke patients

Cited by 3 publications

References 24 publications

A Nationwide Analysis of Outcomes of Weekend Admissions for Intracerebral Hemorrhage Shows Disparities Based on Hospital Teaching Status

A Nationwide Analysis of Outcomes of Weekend Admissions for Intracerebral Hemorrhage Shows Disparities Based on Hospital Teaching Status

Multimorbidities Are Associated to Lower Survival in Ischaemic Stroke: Results from a Brazilian Stroke Cohort (EMMA Study)

Analysis of Records of Patients with Cerebral Stroke Accident and its Correlations with Predisponent Factors

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