No ‘Weekend Effect’ at Specialized Stroke Centers

Aug. 25, 2011 -- If you think hospitals aren’t as good at treating strokes on weekends as they are on weekdays, reconsider. A new study shows that the so-called “weekend effect” doesn’t apply everywhere.

And besides, the stakes are way too high to ever delay seeking care.

No matter what day of the week it is, “if you think you or someone you love is having a stroke, call 911,” says Roger Bonomo, MD, director of stroke care at New York's Lenox Hill Hospital. “Don’t wait until Monday.”

Warning signs of stroke include:

• Sudden weakness or numbness in the face, arm, or leg on one side of the body
• Sudden confusion, trouble speaking, or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

What Is the Weekend Effect of Stroke Treatment?

The weekend effect suggests that people who are admitted to a hospital on weekends with a stroke don’t fare as well as those hospitalized on weekdays. The reasons for this effect vary, but may be because of reduced hospital staff on weekends.

Stroke patients who were admitted to hospitals in New Jersey over the weekend were 5% more likely to die within 90 days than people who were hospitalized during the normal work week unless they were treated at comprehensive stroke centers. The study appears in Stroke.

There are likely several reasons that there was no weekend effect seen at comprehensive stroke centers, James S. McKinney III, MD, tells WebMD in an email. He's an assistant professor of neurology at University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School in New Brunswick, N.J.

“Services [at comprehensive stroke centers], such as physical therapy, [imaging] availability, or acute stroke teams, work around the clock to ensure that all patients are treated the same regardless of the time or day of admission,” McKinney says.

Stroke Centers Offer 'Soup-to-Nuts' Care

“This is another important study adding to the evidence that treatment at stroke centers can improve outcomes for stroke,” Ralph Sacco, MD, tells WebMD. He's chair of neurology at the University of Miami Miller School of Medicine and immediate past president of the American Heart Association. These centers and the doctors who work at them have the “soup-to-nuts ability to handle all kinds of complicated strokes," Sacco says.

Most Americans live within one hour of a stroke center. So access to specialized stroke centers is improving, he says.