Off-Hour Effect on 3-Month Functional Outcome after Acute Ischemic Stroke: A Prospective Multicenter Registry

Title
Off-Hour Effect on 3-Month Functional Outcome after Acute Ischemic Stroke: A Prospective Multicenter Registry
Author(s)
이준Chulho Kim[Chulho Kim]Min Uk Jang[Min Uk Jang]Mi Sun Oh[Mi Sun Oh]Jong-Ho Park[Jong-Ho Park]Kyung-Ho Yu[Kyung-Ho Yu]Beom Joon Kim[Beom Joon Kim]Kyung Bok Lee[Kyung Bok Lee]Jae Kwan Cha[Jae Kwan Cha]Byung-Chul Lee[Byung-Chul Lee]
Keywords
KOREAN STROKE; CASE-FATALITY; SCALE SCORE; WEEKEND; MORTALITY; ADMISSION; CARE; CENTERS; IMPACT; UNITS
Issue Date
201408
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS ONE, v.9, no.8
Abstract
Background and Purpose: The time of hospital arrival may have an effect on prognosis of various vascular diseases. We examined whether off-hour admission would affect the 3-month functional outcome in acute ischemic stroke patients admitted to tertiary hospitals. Methods: We analyzed the 'off-hour effect' in consecutive patients with acute ischemic stroke using multi-center prospective stroke registry. Work-hour admission was defined as when the patient arrived at the emergency department between 8 AM and 6 PM from Monday to Friday and between 8 AM and 1 PM on Saturday. Off-hour admission was defined as the rest of the work-hours and statutory holidays. Multivariable logistic regression was used to analyze the association between off-hour admission and 3-month unfavorable functional outcome defined as modified Rankin Scale (mRS) 3-6. Multivariable model included age, sex, risk factors, prehospital delay time, intravenous thrombolysis, stroke subtypes and severity as covariates. Results: A total of 7075 patients with acute ischemic stroke were included in this analysis: mean age, 67.5 (+/- 13.0) years; male, 58.6%. In multivariable analysis, off-hour admission was not associated with unfavorable functional outcome (OR, 0.89; 95% CI, 0.72-1.09) and mortality (OR, 1.09; 95% CI, 0.77-1.54) at 3 months. Moreover, off-hour admission did not affect a statistically significant shift of 3-month mRS distributions (OR, 0.90; 95% CI, 0.78-1.05). Conclusions: 'Off-hour' admission is not associated with an unfavorable 3-month functional outcome in acute ischemic stroke patients admitted to tertiary hospitals in Korea. This finding indicates that the off-hour effects could be overcome with well-organized stroke management strategies.
URI
http://hdl.handle.net/YU.REPOSITORY/31321http://dx.doi.org/10.1371/journal.pone.0105799
ISSN
1932-6203
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의과대학 > 신경과학교실 > Articles
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