Impact of the weekend effect on outcome after microsurgical clipping of ruptured intracranial aneurysms
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| Titel: | Impact of the weekend effect on outcome after microsurgical clipping of ruptured intracranial aneurysms |
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| Autoren: | Lukas Goertz, Christoph Kabbasch, Muriel Pflaeging, Lenhard Pennig, Kai Roman Laukamp, Marco Timmer, Hanna Styczen, Gerrit Brinker, Roland Goldbrunner, Boris Krischek |
| Quelle: | Acta Neurochir (Wien) |
| Verlagsinformationen: | Springer Science and Business Media LLC, 2021. |
| Publikationsjahr: | 2021 |
| Schlagwörter: | Male, 2. Zero hunger, Original Article - Vascular Neurosurgery - Aneurysm, Microsurgery, Night Care, Endovascular Procedures, Medizin, Angiography, Intracranial Aneurysm, Cerebral Infarction, Aneurysm, Ruptured, Middle Aged, Subarachnoid Hemorrhage, Neurosurgical Procedures, Aged [MeSH], Intracranial Aneurysm/complications [MeSH], Clipping, Night, Angiography [MeSH], Male [MeSH], Subarachnoid Hemorrhage/surgery [MeSH], Aneurysm, Ruptured/surgery [MeSH], Female [MeSH], Functional outcome, Endovascular Procedures/methods [MeSH], Humans [MeSH], Subarachnoid Hemorrhage/mortality [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Night Care [MeSH], Aneurysm, Ruptured/mortality [MeSH], Subarachnoid Hemorrhage/etiology [MeSH], Intracranial Aneurysm/mortality [MeSH], Neurosurgical Procedures/methods [MeSH], After-Hours Care [MeSH], Modified Rankin scale, Cerebral Infarction/mortality [MeSH], Aneurysm, Ruptured/complications [MeSH], Vascular Neurosurgery – Aneurysm, Patient Admission [MeSH], Cerebral Infarction/prevention, Cerebral infarction, Microsurgery [MeSH], Angiographic outcome, Intracranial Aneurysm/surgery [MeSH], 3. Good health, 03 medical and health sciences, Patient Admission, Treatment Outcome, 0302 clinical medicine, After-Hours Care, Humans, Female, Aged, Retrospective Studies |
| Beschreibung: | 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, 08:00–17:59) and (2) on-call duty and microsurgical clipping performed during (a) daytime (Monday–Sunday, 08:00–17:59) 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.” |
| Publikationsart: | Article Other literature type |
| Sprache: | English |
| ISSN: | 0942-0940 0001-6268 |
| DOI: | 10.1007/s00701-020-04689-9 |
| Zugangs-URL: | https://link.springer.com/content/pdf/10.1007/s00701-020-04689-9.pdf https://pubmed.ncbi.nlm.nih.gov/33403431 https://paperity.org/p/259872471/impact-of-the-weekend-effect-on-outcome-after-microsurgical-clipping-of-ruptured https://link.springer.com/content/pdf/10.1007/s00701-020-04689-9.pdf https://www.ncbi.nlm.nih.gov/pubmed/33403431 https://europepmc.org/article/PMC/PMC7886827 https://pubmed.ncbi.nlm.nih.gov/33403431/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886827 https://repository.publisso.de/resource/frl:6449276 https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&origin=inward&scp=85098956999 https://www.ncbi.nlm.nih.gov/pubmed/33403431 https://doi.org/10.1007/s00701-020-04689-9 |
| Rights: | CC BY |
| Dokumentencode: | edsair.doi.dedup.....f16d28d4845da66a5a9a5db7200a04b0 |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | 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, 08:00–17:59) and (2) on-call duty and microsurgical clipping performed during (a) daytime (Monday–Sunday, 08:00–17:59) 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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| ISSN: | 09420940 00016268 |
| DOI: | 10.1007/s00701-020-04689-9 |