Effect of Weekend Admission on In-Hospital Mortality in Patients with Ischemic Stroke

An Analysis of Korean Nationwide Claims Data from 2002 to 2013

Kyoung Hee Cho, Euncheol Park, Chung Mo Nam, Young Choi, Jaeyong Shin, Sang Gyu Lee

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)419-427
Number of pages9
JournalJournal of Stroke and Cerebrovascular Diseases
Volume25
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

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Hospital Mortality
Stroke
Mortality
Confidence Intervals
Hospital Emergency Service
Korea
Proportional Hazards Models
Hospitalization
Population

All Science Journal Classification (ASJC) codes

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

@article{f0c351ad1cdc494082f16e1b7eeacd58,
title = "Effect of Weekend Admission on In-Hospital Mortality in Patients with Ischemic Stroke: An Analysis of Korean Nationwide Claims Data from 2002 to 2013",
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.",
author = "Cho, {Kyoung Hee} and Euncheol Park and Nam, {Chung Mo} and Young Choi and Jaeyong Shin and Lee, {Sang Gyu}",
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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. / Cho, Kyoung Hee; Park, Euncheol; Nam, Chung Mo; Choi, Young; Shin, Jaeyong; Lee, Sang Gyu.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 25, No. 2, 01.02.2016, p. 419-427.

Research output: Contribution to journalArticle

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T1 - Effect of Weekend Admission on In-Hospital Mortality in Patients with Ischemic Stroke

T2 - An Analysis of Korean Nationwide Claims Data from 2002 to 2013

AU - Cho, Kyoung Hee

AU - Park, Euncheol

AU - Nam, Chung Mo

AU - Choi, Young

AU - Shin, Jaeyong

AU - Lee, Sang Gyu

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N2 - 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.

AB - 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.

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