Mechanical thrombectomy and the ‘weekend effect’: does admission time influence outcomes?

Weddell, Jake; Muddegowda, Girish; Natarajan, Indira; Nayak, Sanjeev; Jadun, Changez; Hashim, Zafar; Ferdinand, Phillip; Sanyal, Ranjan; Augustine, Albin; Roffe, Christine

doi:10.7861/fhj.7.1.s3

Cited by 1 publication

(1 citation statement)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The subject examined in our study has already been partially addressed in previous publications with varying results. While Nikoubashman et al [ 18 ] and Wedell et al [ 19 ] could not demonstrate any effect of the time of admission on the outcome or radiological features, Ogbu et al [ 3 ] and Roberts et al [ 20 ] showed increased mortality at the weekend and especially at night. Saad et al [ 21 ] were able to demonstrate increased mortality at weekends only in non-teaching hospitals, which was attributed to the fact that non-teaching hospitals are less often certified stroke centres and have less specialised personnel, such as vascular neurologists, leading to less guideline adherent behaviour, especially at night and on weekends.…”

Section: Discussionmentioning

confidence: 99%

Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends

et al. 2020

View full text Add to dashboard Cite

Objectives The objective of this study was to compare clinical outcome and procedural differences of mechanical thrombectomy (MT) during on-call with regular operating hours. We particularly focused on dosimetric data which may serve as potential surrogates for patient outcome. Methods A total of 246 consecutive patients who underwent MT in acute anterior circulation stroke between November 2017 and March 2020 were retrospectively included. Patients treated (1) during standard operational hours (n = 102), (2) daytime on-call duty (n = 38) and (3) nighttime on-call duty (n = 106) were compared with respect to their pre-interventional status, procedural specifics, including dosimetrics (dose area product (DAP), fluoroscopy time and procedural time), and outcome. Results The collectives treated outside the regular operational hours showed an increased in-hospital mortality (standard operational hours 7% (7/102), daytime on-call duty 16% (6/38), nighttime on-call duty 20% (21/106), p = 0.02). Neither the dosimetric parameters nor baseline characteristics other procedural specifics and outcome parameters differed significantly between groups (p > 0.05 each). In most cases (> 90%), a successful reperfusion was achieved (TICI ≥ 2b). Conclusions We found an increased in-hospital mortality in patients admitted at night and during weekends which was not explained by technical aspects of MT. Key Points • There is an increased mortality of stroke patients admitted at night and on weekends. • This is not explained by technical aspects of mechanical thrombectomy. • There were no statistical differences in the comparison of parameters linked to the radiation exposure, such as DAP, fluoroscopy time and procedure time.

show abstract