- Title
- No Evidence of the "Weekend Effect" in the Northern New South Wales Telestroke Network
- Creator
- Lillicrap, Thomas; Pinheiro, Alex; Parsons, Mark; Levi, Christopher; Garcia-Esperon, Carlos; Spratt, Neil; Miteff, Ferdinand; Garcia-Bermejo, Pablo; Gangadharan, Shyam; Wellings, Thomas; O'Brien, Billy; Evans, James; Alanati, Khaled; Bivard, Andrew
- Relation
- Frontiers in Neurology Vol. 11, Issue February 2020, no. 130
- Publisher Link
- http://dx.doi.org/10.3389/fneur.2020.00130
- Publisher
- Frontiers Research Foundation
- Resource Type
- journal article
- Date
- 2020
- Description
- Background: Admission outside normal business hours has been associated with prolonged door-to-treatment times and poorer patient outcomes, the so called “weekend effect. ” This is the first examination of the weekend effect in a telestroke service that uses multi-modal computed tomography. Aims: To examine differences in workflow and triage between in-hours and out-of-hours calls to a telestroke service. Methods: All patients assessed using the Northern New South Wales (N-NSW) telestroke service from April 2013 to January 2019 were eligible for inclusion (674 in total; 539 with complete data). The primary outcomes measured were differences between in-hours and out-of-hours in door-to-call-to-decision-to-needle times, differences in the proportion of patients confirmed to have strokes or of patients selected for reperfusion therapies or patients with a modified Rankin Score (mRS ≤ 2) at 90 days. Results: There were no significant differences between in-hours and out-of-hours in any of the measured times, nor in the proportions of patients confirmed to have strokes (67.6 and 69.6%, respectively, p = 0.93); selected for reperfusion therapies (22.7 and 22.6%, respectively, p = 0.56); or independent at 3 months (34.8 and 33.6%, respectively, p = 0.770). There were significant differences in times between individual hospitals, and patient presentation more than 4.5 h after symptom onset was associated with slower times (21 minute delay in door-to-call, p = 0.002 and 22 min delay in door-to-image, p = 0.001). Conclusions: The weekend effect is not evident in the Northern NSW telestroke network experience, though this study did identify some opportunities for improvement in the delivery of acute stroke therapies.
- Subject
- telestroke; weekend effect; thrombolysis; thrombectomy; door to needle time; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1442820
- Identifier
- uon:41805
- Identifier
- ISSN:1664-2295
- Language
- eng
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