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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Weekend Effect on in-Hospital Mortality for Ischemic and Hemorrhagic Stroke in US Rural and Urban Hospitals
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Weekend Effect on in-Hospital Mortality for Ischemic and Hemorrhagic Stroke in US Rural and Urban Hospitals

机译：周末对美国农村医院缺血性和出血性中风的临近死亡率的影响

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Introduction: Previous studies have reported a "weekend effect" on stroke mortality, whereby stroke patients admitted during weekends have a higher risk of in-hospital death than those admitted during weekdays. Aims: We aimed to investigate whether patients with different types of stroke admitted during weekends have a higher risk of in-hospital mortality in rural and urban hospitals in the US. Methods: We used data from the 2016 National Inpatient Sample and used logistic regression to assess in-hospital mortality for weekday and weekend admissions among stroke patients aged 18 and older by stroke type (ischemic or hemorrhagic) and rural or urban status. Results: Crude stroke mortality was higher in weekend admissions (p <0.001). After adjusting for confounding variables, in-hospital mortality among hemorrhagic stroke patients was significantly greater (22.0%) for weekend admissions compared to weekday admissions (20.2%, p = 0.009). Among rural hospitals, the in-hospital mortality among hemorrhagic stroke patients was also greater among weekend admissions (36.9%) compared to weekday admissions (25.7%, p = 0.040). Among urban hospitals, the mortality of hemorrhagic stroke patients was 21.1% for weekend and 19.6% for weekday admissions (p = 0.026). No weekend effect was found among ischemic stroke patients admitted to rural or urban hospitals. Conclusions: Our results help to understand mortality differences in hemorrhagic stroke for weekend vs. weekday admissions in urban and rural hospitals. Factors such as density of care providers, stroke centers, and patient level risky behaviors associated with the weekend effect on hemorrhagic stroke mortality need further investigation to improve stroke care services and reduce weekend effect on hemorrhagic stroke mortality.
机译：导言：之前的研究报告了中风死亡率的“周末效应”，即周末入院的中风患者比平日入院的患者有更高的住院死亡风险。目的：我们旨在调查周末入院的不同类型中风患者在美国农村和城市医院的住院死亡率是否较高。方法：我们使用2016年全国住院患者样本的数据，并使用逻辑回归评估18岁及以上中风患者在工作日和周末入院时的住院死亡率，按中风类型（缺血性或出血性）以及农村或城市状态进行评估。结果：周末入院的粗卒中死亡率较高（p<0.001）。调整混杂变量后，出血性卒中患者周末入院的住院死亡率（22.0%）显著高于工作日入院（20.2%，p=0.009）。在农村医院中，出血性卒中患者的住院死亡率在周末入院（36.9%）比工作日入院（25.7%，p=0.040）更高。在城市医院中，出血性卒中患者周末死亡率为21.1%，工作日死亡率为19.6%（p=0.026）。在农村或城市医院住院的缺血性中风患者中未发现周末效应。结论：我们的研究结果有助于了解城市和农村医院周末和工作日收治出血性卒中的死亡率差异。与周末对出血性卒中死亡率的影响相关的因素，如护理人员密度、卒中中心和患者层面的危险行为，需要进一步调查，以改善卒中护理服务，降低周末对出血性卒中死亡率的影响。

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