Tuesday, February 17, 2009

Stroke patients admitted to hospitals during off-hours face greater mortality risk
by Kelly Winget, DCRI Communications

A new study found that stroke patients who are admitted to hospitals at night or on weekends have a higher risk of mortality, despite no real difference in how well hospitals comply with performance goals during regular and off-hours.

The DCRI's Adrian Hernandez, MD, and Wenqin Pan, PhD, were involved with the study. Study results were published in the February issue of Stroke.

Researchers analyzed data from 857 hospitals that were participating in the Get With the Guidelines – Stroke program from 2003 to 2007. They focused on patients who were admitted to the hospital for either acute ischemic stroke (IS) or acute hemorrhagic stroke (HS). The former is a stroke caused by a blood clot that limits the flow of blood to the brain, and the latter is caused by excess bleeding in the brain.

More than half of stroke patients in both categories were admitted to a hospital during off-hours, or outside the hours of 7 a.m. to 6 p.m. on weekdays.

Researchers found that patients who were admitted during off-hours were much more likely to die while in the hospital, even after adjusting for various other factors. In addition to reviewing mortality rates, researchers analyzed how well the hospitals complied with the performance measures that were part of the GWTG program. Researchers found almost no difference in the quality of care, no matter when patients were admitted to the hospitals.

The odds of dying while in the hospital were almost 10% higher for patients with ischemic stroke who were admitted during off-hours, and the odds were even higher for patients with hemorrhagic stroke admitted during the same time.

Researchers recommend further studies to assess if increasing the number of stroke nurses or specialty stroke services at nights and on weekends would help lower the in-hospital mortality risks and if it would be cost-effective for hospitals.

Click here to read the full study.