Differences in mechanical thrombectomy for acute ischemic stroke on weekdays versus nights/ weekends in a Japanese primary stroke core center

Abstract

Objective: The term “weekend effect” refers to an increase in the mortality rate for hospitalizations occurring on weekends versus weekdays. In this study, we investigated whether such an effect exists in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (currently the standard treatment for this condition) at a single center in Japan.Methods: We surveyed 151 patients who underwent mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (75 and 76 patients were treated during daytime and nighttime, respectively) from January 2019 to June 2021. The items evaluated in this analysis were the rate of modified Rankin Scale ≤2 or prestroke scale, mortality, and procedural treatment time.Results: The rates of modified Rankin Scale ≤2 or prestroke scale and mortality at 90 days after treatment did not differ significantly between daytime and nighttime (41.3% vs. 29.0%, p=0.11; 14.7% vs. 11.8%, p=0.61, respectively). The door-to-groin time tended to be shorter during daytime versus nighttime (57 [IQR: 42.5–70] min vs. 70 [IQR: 55–82]) min, p=0.0507).Conclusions: This study did not reveal differences in treatment outcome between daytime and nighttime in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion. Therefore, the “weekend effect” was not observed in our institution.

Endovascular treatment for basilar artery occlusion: whether the “weekend effect” affects time metrics and clinical outcomes at a comprehensive stroke center

“…Mpotsaris et al reported that the patients admitted during nighttime and weekends showed statistically prolonged door-to-reperfusion times; however, it did not affect the rate of revascularization and favorable outcome ( 12 ). This main conclusion was also supported by similar studies by Potts et al ( 8 ), Lin et al ( 9 ), and Omura et al ( 10 ).. They explained that the outpatient clinics did not provide services, which led to the patients being crowded into the emergency department during non-working hours, and subsequently slightly increased door-to-image times.…”