Effect of Weekend Compared With Weekday Stroke Admission on Thrombolytic Use, In-Hospital Mortality, Discharge Disposition, Hospital Charges, and Length of Stay in the Nationwide Inpatient Sample Database, 2002 to 2007
Effect of Weekend Compared With Weekday Stroke Admission on Thrombolytic Use, In-Hospital Mortality, Discharge Disposition, Hospital Charges, and Length of Stay in the Nationwide Inpatient Sample Database, 2002 to 2007
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DOI：
10.1161/strokeaha.110.591081
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发表时间：
2010-10-01
期刊：
影响因子：
8.3
通讯作者：
Barker, Fred G., II
中科院分区：
文献类型：
--
作者：
Hoh, Brian L.;Chi, Yueh-Yun;Barker, Fred G., II
背景和目的-在其他国家已经证实了中风对死亡率的“周末效应”，在美国可能有轻微的影响。我们研究了中风患者在全国住院样本数据库的溶栓治疗的使用，住院死亡率，出院处置，医院收费，和stay. Methods长度的周末效果，全国住院样本2002年至2007年的所有急诊室入院的国际疾病分类，第9次修订代码对应缺血性中风。采用广义线性模型的广义估计方程，调整性别、年龄、种族、季节、中位收入水平、付款人、合并症评分、医院地区、医院位置、教学状况、床位大小和医院年卒中病例量，比较周末与工作日卒中入院溶栓治疗发生率、住院死亡率、出院处置、住院费用和住院时间。同样的分析进行了使用国际疾病分类，第9次修订代码缺血性中风和短暂性脑缺血检查内部有效性的编码规则，可能会发生在区分中风短暂性脑缺血attack.Results-There是599 087缺血性中风急诊室入院：159 906周末入院和439 181平日入院。应用广义线性模型的广义估计方程进行分析，结果显示周末脑卒中患者比平日接受溶栓治疗的可能性略高（OR=1.114; 95%CI =1.039 ~ 1.194; P=0.003），住院总费用略高（效应比=1.011; 95%CI =1.006 ~ 1.017; P
Background and Purpose-A stroke "weekend effect" on mortality has been demonstrated in other countries with a possible slight effect in the United States. We studied patients with stroke in the Nationwide Inpatient Sample database for a weekend effect on thrombolytic use, in-hospital mortality, discharge disposition, hospital charges, and length of stay.Methods-The Nationwide Inpatient Sample 2002 to 2007 was searched for all emergency room admissions for International Classification of Diseases, 9th Revision codes corresponding to ischemic stroke. Generalized estimated equations for generalized linear models were performed, adjusting for gender, age, race, season, median income level, payer, comorbidity score, hospital region, hospital location, teaching status, bed size, and hospital annual stroke case volume to compare weekend versus weekday stroke admission incidence of thrombolytic use, in-hospital mortality, discharge disposition, hospital charges, and length of stay. The same analysis was performed using the International Classification of Diseases, 9th Revision codes for ischemic stroke AND transient cerebral ischemia to check internal validity for coding irregularities that may occur in differentiating stroke from transient ischemic attack.Results-There were 599 087 emergency room admissions for ischemic stroke: 159 906 weekend admissions and 439 181 weekday admissions. Generalized estimated equation for generalized linear model analysis was performed and demonstrated weekend compared with weekday patients with stroke were slightly more likely to receive thrombolytics (OR=1.114; 95% CI=1.039 to 1.194; P=0.003); incur slightly higher total hospital charges (effect ratio=1.011; 95% CI=1.006 to 1.017; P