THURSDAY, March 8, 2007 (HealthDay News) -- Strokes treated on the weekend are more deadly than those attended to on a weekday, Canadian researchers report.
And while the study included only Canadians, the best guess is that the difference in outcome might be even worse in the United States, said Dr. Gustavo Saposnik, assistant professor of medicine at the University of Toronto and lead author of a report in the journal Stroke.
"We don't have information on what's going on in the United States," Saposnik said. "But here, we have universal health insurance with no co-payment. With all the different plans in the United States, it might be a little worse."
Saposnik and his colleagues had information on almost 26,700 people admitted to 606 Canadian hospitals for ischemic stroke from April 2003 to March 2004. Ischemic strokes occur when a clot blocks a brain artery. More than 80 percent of strokes are ischemic; the rest are hemorrhagic, occurring when an artery bursts.
Just about a quarter of those people came to the hospitals on Saturdays or Sundays. After adjusting for age, gender and other complicating factors, the researchers found that people admitted on a weekend had a 14 percent higher risk of dying within seven days than those who came in on weekdays. They were also less likely to survive to go home.
This "weekend effect" was greater for people admitted to rural rather than urban hospitals and if the physician in charge was a general practitioner rather than a specialist, the study found.
The reasons for the difference are not clear, Saposnik said. "There may be some differences in resources in different hospitals on weekends," he said. "We are doing another study trying to address the underlying mechanism for our findings."
Whatever the reason, the experts' advice to people who suspect someone may be having a stroke remains the same no matter what the day of the week, Saposnik said.
"No matter what the time of day, in a rural or an urban area, they should seek medical attention," he said. "Call 911 and get to the nearest emergency department."
Quick action is needed because, in a stroke, "time means brain," Saposnik said. In other words, faster treatment means fewer brain cells will die.
That rule was emphasized by Dr. Larry B. Goldstein, professor of medicine and director of the stroke center at Duke University and chairman of the American Heart Association's Stroke Council.
He offered another suggestion for those who believe a loved one might be experiencing stroke: "Don't put a person in a car. It could be something other than a stroke. Just call 911, and hopefully the system will make sure that the patient gets to the appropriate facility."
Appropriate help should be available "24/7," Goldstein said. There is a national system for accrediting round-the-clock stroke centers, and states including New York, Florida and Massachusetts have their own accrediting mechanisms, he said.
"The difference in weekend admissions found in this study may be real, but the potential benefits of early treatment well outweigh the risk of waiting," Goldstein said.
Stroke symptoms include abrupt difficulty in speaking or understanding, weakness or numbness of an arm or leg and unexpected difficulty walking, he said.
More information
Stroke warning signs and what to do about them are explained by the American Stroke Association.
