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Effect of Weekend Admission on In-Hospital Mortality in Patients with Ischemic Stroke: An Analysis of Korean Nationwide Claims Data from 2002 to 2013

Authors
 Kyoung Hee Cho  ;  Eun-Cheol Park  ;  Chung Mo Nam  ;  Young Choi  ;  Jaeyong Shin  ;  Sang Gyu Lee 
Citation
 Journal of Stroke and Cerebrovascular Diseases, Vol.25(2) : 419-427, 2016 
Journal Title
 Journal of Stroke and Cerebrovascular Diseases 
ISSN
 1052-3057 
Issue Date
2016
MeSH
Adult ; Aged ; Aged, 80 and over ; Brain Ischemia/mortality* ; Databases, Factual ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Patient Admission* ; Proportional Hazards Models ; Republic of Korea ; Stroke/mortality* ; Time Factors ; Young Adult
Keywords
Weekend effect ; frailty model ; in-hospital mortality ; ischemic stroke ; weekend admissions
Abstract
BACKGROUND: Studies conducted on patients with stroke in countries other than Korea demonstrated a phenomenon known as the weekend effect on 7-day, 30-day, and in-hospital mortalities. We studied patients with stroke using nationwide cohort data to determine if there was a weekend effect on mortality in a Korean population. METHODS: Nationwide cohort data, collected from 2002 to 2013, were searched for all hospitalizations via the emergency department due to ischemic stroke. Cox's proportional hazards frailty model was employed, and we adjusted for all patient and hospital characteristics. RESULTS: There were 8957 patients with ischemic stroke admitted via the emergency department: 2632 weekend admissions and 6325 weekday admissions. Of these, 478 (5.3%) patients were dead. After adjusting for patient and hospital characteristics, the frailty model analysis revealed significantly higher in-hospital mortality in patients admitted on weekends than in those admitted on weekdays (hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.01-1.47). We obtained consistent results for the 30-day mortality findings (HR, 1.27; 95% CI, 1.04-1.55). However, no significant differences were observed in the 7-day mortality (HR, 1.13; 95% CI, .88-1.45). CONCLUSIONS: Weekend admission for ischemic stroke was significantly associated with higher in-hospital and 30-day mortality after adjusting for individual characteristics and hospital factors.
Full Text
http://www.sciencedirect.com/science/article/pii/S1052305715005534
DOI
10.1016/j.jstrokecerebrovasdis.2015.10.014
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146296
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