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Invasiveness and Clinical Outcomes of Off-Hour Admissions in Patients with Intracerebral Hemorrhage.
- Source :
- Journal of Stroke & Cerebrovascular Diseases; Feb2020, Vol. 29 Issue 2, pN.PAG-N.PAG, 1p
- Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>Whether time of hospital admission-during or outside regular working hours-affects functional outcome in intracerebral hemorrhage (ICH) is unestablished as previous analyses have focused on mortality only. We here investigate whether on- versus off-hour hospital admission in ICH is associated with levels of invasiveness and clinical outcomes.<bold>Methods: </bold>Based on the UKER registry (NCT03183167) we grouped ICH-patients according to on- versus off-hour hospital admission. Primary outcome measures was functional outcome after 3 months using the modified Rankin scale (mRS) dichotomized into favorable (mRS = 0-3) and unfavorable (mRS = 4-6). Multivariate regression analyses were used to adjust for baseline imbalances, and subgroup analyses were performed to explore associations of on- versus off-hour admission with invasiveness of therapeutic interventions.<bold>Results: </bold>A total of 438/1269 (34.5%) of ICH-patients were admitted during regular working hours. Mortality rates were not significantly different among patients with on- versus off-hour admission. On-hour patients showed a significantly larger proportion of patients with favorable outcome (on-hour: mRS = 0-3 after 3 months: 176/416 (42.3%) versus off-hour: 265/784 (33.8%); P = .004). Analysis of invasive therapeutic interventions revealed that likelihood of favorable outcome was significantly increased among on-hour admitted patients who did not require neurosurgical interventions (no external ventricular drain n = 349, OR: 1.67[1.13-2.48], P < .05; no hematoma evacuation surgery n = 423, OR: 1.51[1.07-2.14], P < .05).<bold>Conclusion: </bold>This study verified an "off-hour effect" in ICH that relates to functional outcome, rather than mortality, and which may be linked to different levels of invasive therapeutic interventions in patients admitted during off-hour. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10523057
- Volume :
- 29
- Issue :
- 2
- Database :
- Supplemental Index
- Journal :
- Journal of Stroke & Cerebrovascular Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 141111269
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104505