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Impact of the weekend effect on outcome after microsurgical clipping of ruptured intracranial aneurysms.
Goertz, Lukas; Kabbasch, Christoph; Pflaeging, Muriel; Pennig, Lenhard; Laukamp, Kai Roman; Timmer, Marco; Styczen, Hanna; Brinker, Gerrit; Goldbrunner, Roland; Krischek, Boris.
Afiliação
  • Goertz L; Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany. lukas.goertz@uk-koeln.de.
  • Kabbasch C; Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany. lukas.goertz@uk-koeln.de.
  • Pflaeging M; Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
  • Pennig L; Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
  • Laukamp KR; Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
  • Timmer M; Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
  • Styczen H; Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
  • Brinker G; Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
  • Goldbrunner R; Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
  • Krischek B; Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
Acta Neurochir (Wien) ; 163(3): 783-791, 2021 03.
Article em En | MEDLINE | ID: mdl-33403431
ABSTRACT

BACKGROUND:

The "weekend effect" describes the assumption that weekend and/or on-call duty admission of emergency patients is associated with increased morbidity and mortality rates. For aneurysmal subarachnoid hemorrhage, we investigated, whether presentation out of regular working hours and microsurgical clipping at nighttime correlates with worse patient outcome.

METHODS:

This is a retrospective review of consecutive patients that underwent microsurgical clipping of an acutely ruptured aneurysm at our institution between 2010 and 2019. Patients admitted during (1) regular working hours (Monday-Friday, 0800-1759) and (2) on-call duty and microsurgical clipping performed during (a) daytime (Monday-Sunday, 0800-1759) and (b) nighttime were compared regarding the following outcome parameters operation time, treatment-related complications, vasospasm, functional outcome, and angiographic results.

RESULTS:

Among 157 enrolled patients, 104 patients (66.2%) were admitted during on-call duty and 48 operations (30.6%) were performed at nighttime. Admission out of regular hours did not affect cerebral infarction (p = 0.545), mortality (p = 0.343), functional outcome (p = 0.178), and aneurysm occlusion (p = 0.689). Microsurgical clipping at nighttime carried higher odds of unfavorable outcome at discharge (OR 2.3, 95%CI 1.0-5.1, p = 0.039); however, there were no significant differences regarding the remaining outcome parameters. After multivariable adjustment, clipping at nighttime did not remain as independent prognosticator of short-term outcome (OR 2.1, 95%CI 0.7-6.2, p = 0.169).

CONCLUSIONS:

Admission out of regular working hours and clipping at nighttime were not independently associated with poor outcome. The adherence to standardized treatment protocols might mitigate the "weekend effect."
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Aneurisma Roto / Plantão Médico / Microcirurgia / Assistência Noturna Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Neurochir (Wien) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Aneurisma Roto / Plantão Médico / Microcirurgia / Assistência Noturna Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Acta Neurochir (Wien) Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha