Weekend stroke poses higher death risk - Study

Patients having stroke on the weekend are at higher risk of death than those who have it between Monday and Friday, according to a new Canadian study published Thursday in the journal Stroke: Journal of the American Heart Association.

Partly funded by the Heart Stroke Foundation of Canada and the Canadian Institute for Health Research, the researchers at the University of Toronto looked at 26,676 patients admitted at 606 hospitals across Canada from April 2003 to March 2004.

After observing the medical data of those stroke patients, the researchers found that those who were admitted to the hospital on a Saturday or Sunday had a 13 percent increased risk of dying within seven days than those who admitted on weekdays.

The Canadian study showed that the fatality rate over the next 7 days was 7.4% among the 20,047 patients admitted on weekdays, and 8.5 percent for the 6,629 patients admitted on weekends. Patients admitted on the weekend on average were 75 years of age, while those admitted during the week were 74.

The risk was equivalent for patients who died after being discharged. Mortality rate in stroke patients who were admitted on the weekends was 16.4 per cent, while 15.3 per cent admitted on weekdays passed away after leaving the hospital.

"If the 'weekend effect' occurs in a socialized health care system (like Canada's), it is likely that the effect may be larger in other settings," said Dr. Gustavo Saposnik, the lead author of the study who is also director of the Stroke Research Unit Division of Neurology at the University of Toronto.

Interestingly, the so-called "weekend effect" was even increased when patients went to a rural hospital instead of an urban one, and when the physician in charge was a general practitioner rather than a specialist. The risk was equal for both men and women, the study said.

Researchers say a relative lack of resources or expertise and healthcare providers over the weekend may affect the stroke mortality rate, though, they did not elaborate and said further study was needed.

However, experts say no one with stroke-like symptoms should hesitate to seek medical treatment on weekends, or wait until the weekend is over, as at the time of treating stroke every second counts.

"What is really novel in our work beyond the discovery of the 'weekend effect' on ischemic stroke is the subgroup analysis in other settings/characteristics and the identification of variables associated with the 'weekend effect,'" said Saposnik.

Still, patients should keep in mind that "Time is brain, so the sooner the patient seeks medical attention, the higher the chance of better outcome, no matter the day, time or living area," Gustavo said.

The influence of the death rate in weekend admissions may also be greater in a non-teaching hospital and if the patient required treatment in the intensive care unit (ICU).