A Bad Time to Have a Stroke

No time is a good time to have a stroke, but if you had a choice, you should opt for Monday through Friday. Weekend hospital admissions are known to be associated with a higher rate of in-hospital mortality, and a new study, published in the journal Stroke, shows that stroke is one of those conditions that follows this trend.

All hospital admissions for ischemic stroke in Canada over 12 months were analyzed, using the national Hospital Morbidity Database. There were over 26,500 patients admitted to 600+ hospitals in the 12 months. Almost ¼ were admitted on a Saturday or Sunday. Those admitted on weekends were older and more often male, compared to the weekday stroke admissions. Overall, the death rate within the first 7 days was 7.6%. It was 8.5% for weekend, and 7.4% for weekday admissions. Mortality at discharge was 16.4% for weekend patients vs. 15.3% for weekday admissions; moreover, weekend stroke patients were less likely to be discharged to their homes.

The overall weekend effect meant that stroke victims were 14% more likely to have a bad outcome than those admitted on a weekday. Further analyses showed similar trends for weekend stroke admissions in rural hospitals, to the ICU, or treatment was by a non-specialist physician.

Before blaming the hospitals and their staffing, one should consider that stroke may, in itself, be more common on weekends. This may be because of greater indulgence in alcohol or drugs, and the greater likelihood of celebrations or other stress-producing situations. (However, a report in the New England Journal of Medicine this week squarely blames a shortfall in care as the cause of a similar weekend increase in heart attack deaths.)

Whatever the reason, it’s still vital that people who experience the possible early signs of a stroke or transient ischemic attack get to the nearest hospital as quickly as possible – whatever you do, don’t wait for Monday!