J Cerebrovasc Endovasc Neurosurg.  2023 Sep;25(3):297-305. 10.7461/jcen.2023.E2023.01.006.

Differences in mechanical thrombectomy for acute ischemic stroke on weekdays versus nights/ weekends in a Japanese primary stroke core center

Affiliations
  • 1Department of Neurosurgery, Seijinkai Shimizu Hospital, Kyoto, Japan

Abstract


Objective
The term “weekend effect” refers to an increase in the mortality rate for hospitalizations occurring on weekends versus weekdays. In this study, we investigated whether such an effect exists in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (currently the standard treatment for this condition) at a single center in Japan.
Methods
We surveyed 151 patients who underwent mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (75 and 76 patients were treated during daytime and nighttime, respectively) from January 2019 to June 2021. The items evaluated in this analysis were the rate of modified Rankin Scale ≤2 or prestroke scale, mortality, and procedural treatment time.
Results
The rates of modified Rankin Scale ≤2 or prestroke scale and mortality at 90 days after treatment did not differ significantly between daytime and nighttime (41.3% vs. 29.0%, p=0.11; 14.7% vs. 11.8%, p=0.61, respectively). The door-to-groin time tended to be shorter during daytime versus nighttime (57 [IQR: 42.5–70] min vs. 70 [IQR: 55–82]) min, p=0.0507).
Conclusions
This study did not reveal differences in treatment outcome between daytime and nighttime in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion. Therefore, the “weekend effect” was not observed in our institution.

Keyword

Weekend effect; Thrombectomy; Vessel occlusion; Acute ischemic stroke; Treatment procedure time; Primary stroke core center

Figure

  • Fig. 1. This figure shows staff to MT during the nighttime zone (White circle: A neurosurgeon and nurse on duty, Black circle: A neurointervention physician, Gray circle: nurse until 21:00, White triangle: A nurse managing the night shift, Black triangle: An on-call nurse). LVO, large vessel occlusion; MT, mechanical thrombectomy


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