Study suggests poorer outcomes for patients with stroke hospitalized on weekends

A study of patients with stroke admitted to English National Health Service public hospitals suggests that patients who were hospitalized on weekends were less likely to receive urgent treatments and had worse outcomes, according to a report published Online First by Archives of Neurology.

Studies from other countries have suggested higher mortality in patients who were admitted to the hospital on weekends for a variety of medical conditions, a phenomenon known as "the weekend effect." However, other studies have not identified an association between the day of admission and mortality rates due to stroke, so the debate over "the weekend effect" continues, according to the study background.

William L. Palmer, M.A., M.Sc., of Imperial College and the National Audit Office, and colleagues conducted a study of patients admitted to hospitals with stroke from April 2009 through March 2010, accounting for 93,621 admissions.

Performance across five of six measures was lower on weekends, with one of the largest disparities seen in rates of same-day brain scans (43.1 percent on weekends compared with 47.6 percent on weekdays). Also, the rate of seven-day, in-hospital mortality for Sunday admissions was 11 percent compared with a mean (average) of 8.9 percent for weekday admissions, according to study results.

"We calculated that approximately 350 potentially avoidable in-hospital deaths occur within seven days each year and that an additional 650 people could be discharged to their usual place of residence within 56 days if the performance seen on weekdays was replicated on weekends," the authors comment.