Epidemiological chronorisk of stroke

Pasqualetti, P; Natali, G; Casale, R; Colantonio, D

doi:10.1111/j.1600-0404.1990.tb00933.x

Cited by 59 publications

(18 citation statements)

References 18 publications

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“…There are also reports of an increased stroke incidence on weekends [6, 7], although other studies found no apparent trend in stroke incidence over the days of the week [8,9,10]. A study examining the influence of the day of the week of admission on the length of hospital stay in stroke patients reported that patients with ischemic stroke admitted on Tuesdays or Wednesdays had the longest length of hospital stay [11].…”

Section: Introductionmentioning

confidence: 99%

Increase of Stroke Incidence after Weekend Regardless of Traditional Risk Factors: Takashima Stroke Registry, Japan; 1988–2003

et al. 2007

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Background and Purpose: The study purpose was to identify patterns of variation in stroke incidence among days of the week and examine if it is modified by conventional stroke risk factors: hypertension, diabetes, drinking and smoking. Methods: Data were obtained from the Takashima Stroke Registry, which covers a stable population of roughly 55,000 residents of Takashima County in central Japan. A total of 1,773 stroke cases (men: 943 and women: 830) occurred between 1988 and 2003. We divided the days into 3 groups: ‘weekend’, ‘after weekend’ and ‘rest of the week’, and calculated stroke incidence rates and incidence rate ratios. To identify the effect of conventional risk factors on the variation, proportion of differences between observed and expected stroke incidences were considered. Results: The stroke incidence for the after weekend group (250.1 per 100,000 person years, 95% CI: 222.0–278.3) was higher than for the other day groups among men. The after weekend increase was observed mainly among older men aged 65 years or more. Among the stroke subtypes, the incidence for cerebral infarction was highest in the after weekend group (857.2, 95% CI: 730.6–983.8) and was 1.37 times (95% CI: 1.12–1.68) higher than in the rest of the week group. Tendency of after weekend increase was observed regardless of the presence or absence of risk factor history. Conclusions: Week day variation for stroke was observed predominantly among older men regardless of presence and absence of risk factor history. Information about the weekly trend regarding episode of increased stroke incidence can be used as a surrogate predictor for stroke onset and would be helpful in designing more effective insights for preventive strategies.

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Section: Introductionmentioning

confidence: 99%

Increase of Stroke Incidence after Weekend Regardless of Traditional Risk Factors: Takashima Stroke Registry, Japan; 1988–2003

et al. 2007

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“…9 In adults, the incidence of stroke increases during weekends and other stressful periods. [10][11][12] Previous studies 13,14 have demonstrated differences in the quality of care and clinical outcomes in adult patients with stroke admitted on weekdays versus weekends. However, there are no data available on differences in clinical outcomes among pediatric stroke patients admitted on weekends versus weekdays.…”

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confidence: 99%

Weekend Effect in Children With Stroke in the Nationwide Inpatient Sample

Adil

Vidal

Beslow

2016

Stroke

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Background and Purpose-Studies have demonstrated differences in clinical outcomes in adult patients with stroke admitted on weekdays versus weekends. The study's objective was to determine whether a weekend impacts clinical outcomes in children with ischemic stroke and hemorrhagic stroke. Methods-Children aged 1 to 18 years admitted to US hospitals from 2002 to 2011 with a primary discharge diagnosis of ischemic stroke or hemorrhagic stroke were identified by International Classification of Disease, 9th Revision, codes. Logistic regression estimated odds ratios and 95% confidence intervals for in-hospital mortality and discharge to a nursing facility among children admitted on weekends (Saturday and Sunday) versus weekdays (Monday to Friday), adjusting for potential confounders. Results-Of 8467 children with ischemic stroke, 28% were admitted on a weekend. Although children admitted on weekends did not have a higher in-hospital mortality rate than those admitted on weekdays (4.1% versus 3.3%; P=0.4), children admitted on weekends had a higher rate of discharge to a nursing facility (25.5% versus 18.6%; P=0.003). After adjusting for age, sex, and confounders, the odds of discharge to a nursing facility remained increased among children admitted on weekends (odds ratio, 1.5; 95% confidence interval, 1.1-1.9; P=0.006). Of 10 919 children with hemorrhagic stroke, 25.3% were admitted on a weekend. Children admitted on weekends had a higher rate of in-hospital mortality (12% versus 8%; P=0.006). After adjusting for age, sex, and confounders, the odds of in-hospital mortality remained higher among children admitted on weekends (odds ratio, 1.4; 95% confidence interval, 1.1-1.9; P=0.04). Conclusions-There seems to be a weekend effect for children with ischemic and hemorrhagic strokes. Quality improvement initiatives should examine this phenomenon prospectively.

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“…[1][2][3] However, hospitals face shortages of staff and specialized services during those periods. Previous studies have shown increased mortality for different conditions or procedures such as cancer, aortic aneurysm, duodenal ulcer, epiglottitis, and pulmonary embolism, among others, during weekend admissions.…”

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confidence: 99%

Weekends: A Dangerous Time for Having a Stroke?

Saposnik

Baibergenova²,

Bayer³

et al. 2007

Stroke

309

252

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Background and Purpose-Weekend admissions are associated with higher in-hospital mortality. However, limited information is available concerning the "weekend effect" on stroke mortality. Our aim was to evaluate the impact of weekend admissions on stroke mortality in different settings. Methods-We analyzed all hospital admissions for ischemic stroke from April 2003 to March 2004 through the Hospital Morbidity Database. The Hospital Morbidity Database is a national database that contains patient-level sociodemographic, diagnostic, procedural, and administrative information including all acute care facilities across Canada. The major inclusion criterion was admission to an acute care facility with a principal diagnosis of ischemic stroke. Clinical variables and facility characteristics were included in the analysis. Results-Overall, 26 676 patients were admitted to 606 hospitals for ischemic stroke. Weekend admissions comprised 6629 (24.8%) of all admissions. Seven-day stroke mortality was 7.6%. Weekend admissions were associated with a higher stroke mortality than weekday admissions (8.5% vs 7.4%; odds ratio, 1.17; 95% CI, 1.06 to 1.29). Mortality was similarly affected among patients admitted to rural versus urban hospitals or when the most responsible physician was a general practitioner versus specialist. In the multivariable analysis, weekend admissions were associated with higher early mortality (odds ratio, 1.14; 95% CI, 1.02 to 1.26) after adjusting for age, sex, comorbidities, and medical complications. Conclusions-Stroke patients admitted on weekends had a higher risk-adjusted mortality than did patients admitted on weekdays. Disparities in resources, expertise, and healthcare providers working during weekends may explain the observed differences in weekend mortality.

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Epidemiological chronorisk of stroke

Cited by 59 publications

References 18 publications

Increase of Stroke Incidence after Weekend Regardless of Traditional Risk Factors: Takashima Stroke Registry, Japan; 1988–2003

Increase of Stroke Incidence after Weekend Regardless of Traditional Risk Factors: Takashima Stroke Registry, Japan; 1988–2003

Weekend Effect in Children With Stroke in the Nationwide Inpatient Sample

Weekends: A Dangerous Time for Having a Stroke?

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