周末入院与工作日入院对中国急性缺血性卒中患者死亡率的影响：来自中国急性缺血性卒中治疗结局登记处的数据分析
Effect of weekend versus weekday admission on the mortality of acute ischemic stroke patients in China: an analysis of data from the Chinese acute ischemic stroke treatment outcome registry.
作者信息
Huang Diandian, Lu Yuxuan, Sun Yongan, Sun Wei, Huang Yining, Tai Liwen, Li Guozhong, Chen Huisheng, Zhang Guiru, Zhang Lei, Sun Xuwen, Qiu Jinhua, Wei Yan, Jin Haiqiang
机构信息
Department of Neurology, Peking University First Hospital, Beijing, China.
Department of Neurology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
出版信息
Front Neurol. 2023 Jul 17;14:1206846. doi: 10.3389/fneur.2023.1206846. eCollection 2023.
BACKGROUND
Due to disparities in medical resources in rural and urban areas as well as in different geographic regions in China, the effect of weekend versus weekday admission on the outcomes of acute ischemic stroke (AIS) patients is unknown. Our aim was to investigate whether the outcomes of AIS patients differ according to the day of admission in China.
METHODS
The data were extracted from the Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR), a multicenter prospective study database of patients diagnosed with AIS. The chi-square test () and logistic regression were used to assess mortality for weekday and weekend admissions among AIS patients stratified by rural or urban status and geographic region (including the eastern, northeastern, central, and western regions).
RESULTS
In total, 9,256 patients were included in this study. Of these patients, 57.2% were classified as urban, and 42.8% were classified as rural. A total of 6,760 (73%) patients were admitted on weekdays, and 2,496 (27%) were admitted on weekends. There was no significant difference in the mortality rate among patients admitted on weekends compared with those admitted on weekdays in urban (7.5% versus 7.4%) or rural areas (8.8% versus 8.1%; > 0.05). The mortality rate was the highest among patients admitted on weekends and weekdays (11.6% versus 10.3%) in the northeastern area, without statistical significance before and after adjusting for the patients' background characteristics ( > 0.05). In addition, regression analysis revealed that the mortality of patients admitted on weekdays was more likely to be influenced by regional subgroup, hospital level and intravenous thrombolysis than that of patients admitted on weekends.
CONCLUSION
The weekend effect was not observed in the mortality of patients with AIS regardless of rural-urban status or geographic region in China.
背景
由于中国城乡以及不同地理区域医疗资源存在差异，急性缺血性卒中（AIS）患者周末入院与工作日入院对其预后的影响尚不清楚。我们的目的是调查在中国AIS患者的预后是否因入院日期而异。
方法
数据取自中国急性缺血性卒中治疗结局登记库（CASTOR），这是一个对诊断为AIS的患者进行的多中心前瞻性研究数据库。采用卡方检验（）和逻辑回归分析，对按城乡状况和地理区域（包括东部、东北部、中部和西部地区）分层的AIS患者中工作日和周末入院的死亡率进行评估。
结果
本研究共纳入9256例患者。其中，57.2%被归类为城市患者，42.8%被归类为农村患者。共有6760例（73%）患者在工作日入院，2496例（27%）患者在周末入院。城市地区周末入院患者与工作日入院患者的死亡率无显著差异（7.5%对7.4%），农村地区也无显著差异（8.8%对8.1%；>0.05）。东北地区周末和工作日入院患者的死亡率最高（11.6%对10.3%），在调整患者背景特征前后均无统计学意义（>0.05）。此外，回归分析显示，与周末入院的患者相比，工作日入院患者的死亡率更易受区域亚组、医院级别和静脉溶栓的影响。
结论
在中国，无论城乡状况或地理区域如何，AIS患者的死亡率均未观察到周末效应。
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