Omura Naoki, Kakita Hiroto, Fukuo Yusuke, Shimizu Fuminori
Department of Neurosurgery, Seijinkai Shimizu Hospital, Kyoto, Japan.
J Cerebrovasc Endovasc Neurosurg. 2023 Sep;25(3):297-305. doi: 10.7461/jcen.2023.E2023.01.006. Epub 2023 Jul 11.
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.
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.
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).
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.
“周末效应”一词指的是与工作日相比,周末住院患者的死亡率有所上升。在本研究中,我们调查了在日本的一个单一中心,对于急性缺血性卒中伴大血管闭塞(目前针对这种情况的标准治疗方法)接受机械取栓治疗的患者是否存在这种效应。
我们调查了2019年1月至2021年6月期间151例接受急性缺血性卒中伴大血管闭塞机械取栓治疗的患者(分别有75例和76例患者在白天和夜间接受治疗)。本分析中评估的项目包括改良Rankin量表评分≤2或卒中前量表评分、死亡率和手术治疗时间。
治疗后90天时,白天和夜间的改良Rankin量表评分≤2或卒中前量表评分以及死亡率无显著差异(分别为41.3%对29.0%,p = 0.11;14.7%对11.8%,p = 0.61)。白天的门到股动脉时间往往比夜间短(57 [四分位间距:42.5 - 70]分钟对70 [四分位间距:55 - 82]分钟,p = 0.0507)。
本研究未发现急性缺血性卒中伴大血管闭塞接受机械取栓治疗的患者在白天和夜间的治疗结果存在差异。因此,在我们机构未观察到“周末效应”。