Certified Stroke Centers Are Winners

Stroke patients receive great care at certified stroke centers

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Stroke patients admitted on weekends have a higher chance of dying. But that's not the case for those that seek treatment at a hospital with a state-certified stroke center.

Stroke patients who were admitted to hospitals in New Jersey on a weekend had a death rate that was 5 percent higher within 90 days of hospitalization than those admitted during the week. The death rate remained unchanged at certified stroke centers regardless of day of the week.

"Seek care at a certified stroke center if possible."

Dr. James McKinney, the lead researcher and assistant professor of neurology at the University of Medicine and Dentistry at New Jersey-Robert Wood Johnson Medical School, said the "weekend effect" suggests that patients who are treated or hospitalized over the weekend will receive different care and have worse outcomes, which could account for several thousand deaths in the United States.

Seven years ago, the state of New Jersey passed the Stroke Centers Act, which allows hospitals to apply for designation as a comprehensive stroke center or primary stroke center, dependent on their level of specialized care. Both must be able to evaluate, stabilize and provide emergency care for acute stroke victims.

But, comprehensive stroke centers also must be prepared to treat complex stroke cases. Many other states also award similar designations.

Investigators examined records of 134,441 stroke patients discharged from 88 private acute care hospitals in New Jersey between 1997 and 2007. About 23 percent were admitted to one of 12 comprehensive stroke centers, 52 percent were admitted to a primary stroke center and the remainder went to non-stroke centers. Of those studied, 28 percent were admitted on a weekend.

Patients admitted during the weekend had a significantly higher death rate at 17.2 percent within 90 days compared to patients hospitalized on weekdays at 16.5 percent. After adjustments for demographics and other factors, the overall increased death rate was 5 percent.

Researchers also found that patients were more likely to be admitted to comprehensive stroke centers on the weekend. In addition, patients hospitalized at a comprehensive or primary stroke center on a weekend had a 5 percent lower 90-day mortality rate compared to those admitted to a non-stroke center.

Dr. McKinney said that a reduction in 90 day mortality between 1996-1997 and 2006-2007 after the 2004 creation of the stroke centers may indicate that the designation process has had a positive impact on stroke care as a whole across the state.

The research was published in Stroke: Journal of the American Heart Association.

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Review Date: 
August 26, 2011
Last Updated:
August 29, 2011