Strokes 12% more deadly on weekends, study shows

People who go to the hospital with a stroke on a weekend are 12% more likely to die within a week than those who go on a weekday, Canadian researchers reported Monday. It was the second major study finding that there is a higher risk of dying if a person is hospitalized with a stroke on a weekend and, although it was an effort to isolate the reasons for the increased risk, it failed to find any clear reason for the discrepancy, the researchers reported in the journal Neurology. Previous research has found an increased risk of death associated with hospitalization for other conditions, such as cancer and pulmonary embolism, on the weekend. Experts generally attribute the increased risk to reduced staffing on the weekend, decreased availability of specialists and a reduced likelihood that patients will get prompt specialized tests.

The results do not mean that patients should not go to hospitals on the weekend. That would greatly increase their risk of dying. Rather, it means that there is a slightly increased risk of mortality associated with medical events that require hospitalization on Saturday and Sunday.

In 2007, researchers reported on a study of 26,676 stroke patients admitted to 606 Canadian hospitals from April 2003 to March 2004. About a quarter of those patients were admitted on the weekend. The study found that mortality within the seven days following hospital admission was 14% higher for those admitted on the weekend.

In the new study, Dr. Moira K. Kapral, who is now at the University of Toronto, are her colleagues studied 20,657 patients who were admitted to 11 stroke centers in Ontario between July 1, 2003, and March 30, 2008. They found that the mortality rate was 7.0% for those admitted during weekdays, compared with 8.1% for those admitted on weekends. The numbers of patients with moderate and severe strokes admitted to hospitals on weekend days were similar to those on weekdays, but the number with mild strokes was lower, suggesting that those patients delayed going to the hospital. The team found no obvious differences in care on the weekend. Kapral suggested that the difference in mortality rate probably reflected "an accumulation of small deficiencies in care" -- including secondary treatments that may seem minor but that are crucial for recovery.

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