Universität zu Köln

Goertz, Lukas, Kabbasch, Christoph, Pflaeging, Muriel, Pennig, Lenhard, Laukamp, Kai Roman, Timmer, Marco, Styczen, Hanna, Brinker, Gerrit, Goldbrunner, Roland and Krischek, Boris (2021). Impact of the weekend effect on outcome after microsurgical clipping of ruptured intracranial aneurysms. Acta Neurochir., 163 (3). S. 783 - 792. WIEN: SPRINGER WIEN. ISSN 0942-0940

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Pflaeging, Muriel UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Lenhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Laukamp, Kai Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmer, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Styczen, Hanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinker, Gerrit UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Krischek, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-577536
DOI:	10.1007/s00701-020-04689-9
Journal or Publication Title:	Acta Neurochir.
Volume:	163
Number:	3
Page Range:	S. 783 - 792
Date:	2021
Publisher:	SPRINGER WIEN
Place of Publication:	WIEN
ISSN:	0942-0940
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HOSPITAL ADMISSION; ISCHEMIC-STROKE; RISK-FACTORS; MORTALITY; SURGERY; TIME Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57753