Background: Reduced hospital staffing out of hours and at weekends has been associated with adverse patient outcomes. Following recent study showing reduced adjusted mortality after acute heart disease during large cardiology conferences, we explored acute ischemic stroke (AIS) outcomes and practice patterns during stroke conferences.
Method: We compared 7-day in-hospital mortality, all in-hospital mortality, and number of stroke admissions per day, baseline demographics, and length of stay (LOS) for patients admitted on stroke conferences days (SCD) and matched non-conference days (NCD) in the three weeks before and after. The table shows which countries’ data were used for each of the three conferences. Conferences were chosen if a large portion of stroke providers attended from each country under study. We used the Global Comparators data set that represents predominantly academic teaching hospitals from across Europe, Australia and the US. Outcomes were adjusted for country, age, sex, and comorbidity score, whether a patient was transferred into the hospital or had an emergency admission to the hospital in the previous 30 days.
Results: We identified 6684 patients (SCD 940, NCD 5744), and found no difference in raw and adjusted outcomes between groups. The frequency of stroke admissions and LOS were similar. Mortality was 7.77% during SDC, 8.2% on NDC and 7-day in-hospital mortality was 4.04% during SDC and 4.65% on NDC. Using regression analysis, admission on a conference day was not a predictor for in-hospital mortality or 7-day in-hospital mortality.
Discussion: We found no differences in practice pattern and outcomes for patients admitted with AIS during stroke conferences in this international dataset. Future monitoring of outcomes during large medical conferences using larger samples should focus on exact staffing ratio changes during conference times to assure robust patient care at all times.