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|Title:||No Evidence of the "Weekend Effect" in the Northern New South Wales Telestroke Network||Authors:||O'Brien, Bill ;Evans, James W ;Lillicrap, T.;Pinheiro, A.;Miteff, F.;Garcia-Bermejo, P.;Gangadharan, S.;Wellings, T.;Alanati, K.;Bivard, A.;Parsons, M.;Levi, C.;Garcia-Esperon, C.;Spratt, N.J.||Affliation:||Central Coast Local Health District
The University of Newcastle
|Issue Date:||Feb-2020||Source:||11:130||Journal title:||Frontiers in neurology||Department:||Neurology||Abstract:||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.||URI:||https://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1767||DOI:||10.3389/fneur.2020.00130||Pubmed:||https://www.ncbi.nlm.nih.gov/pubmed/32174885||ISSN:||1664-2295||Publicaton type:||Journal Article||Keywords:||Stroke
|Appears in Collections:||Neurology|
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