Abstract W P319: Effect of Weekend Admission on Inhospital Outcomes AmongChildren with Ischemic and Hemorrhagic Strokes
Background and Objective: Prior studies have demonstrated differences in the quality of care and clinical outcomes in adult stroke patients admitted on weekdays compared with weekends . The objective of this study was to determine the effect of weekend admission on clinical outcomes in children with ischemic stroke (IS) and hemorrhagic stroke (HS).
Methods: Patients admitted to US hospitals between 2002 to 2011 with a primary discharge diagnosis of IS and HS (age 1-18 years) were identified by ICD-9 codes. Using logistic regression, we estimated the odds ratio (OR) and 95% confidence intervals (CI) for in-hospital mortality, and discharge to nursing facilities among children (separately for IS and HS) admitted on weekends versus weekdays, adjusting for potential confounders.
Results: Of 8,467 children with IS, 28 % were admitted on a weekend. Children admitted on weekends had higher rates of discharge to nursing facility (25.5 % versus 18.6 % p=0.003). In-hospital mortality was not different among children admitted on weekends compared with weekdays. After adjusting for age, gender, and confounding factors, discharge to nursing facilities [(OR) 1.5, 95% (CI) (1.1-1.9, p=0.006)] remains significantly high among children admitted on weekends as compared to those admitted on weekdays. Of 10,919 children with HS, 25.3 % were admitted on a weekend. Children admitted on weekends had higher rates of in-hospital mortality (12 % versus 8% p=0.006). Rates of discharge to nursing facility was not different among children admitted on weekends compared with weekdays. After adjusting for age, gender, and confounding factors, in-hospital mortality [(OR) 1.4, 95% (CI) (1.1-1.9, p=0.04)] remains significantly high among children admitted on weekends as compared to those admitted on weekdays.
Conclusion: IS children admitted on weekends were more likely to be discharged to nursing facility while HS children admitted on weekends had higher rates of in-hospital mortality. Such observations point to prominent disparity in care on weekends among pediatric stroke patients.
Author Disclosures: M.M. Adil: None. G.A. Vidal: None. A.A. Malik: None. F. Khursheed: None. A.I. Qureshi: None.
- © 2015 by American Heart Association, Inc.