Abstract 4365944: Impact of Weekend Admission on In-Hospital Outcomes of Endovascular Thrombectomy for Acute Ischemic Stroke: National Inpatient Sample Analysis

Abstract

Background: Disparities in hospital staffing and resource availability during weekends may delay treatment and worsen clinical outcomes for patients with acute ischemic stroke (AIS) undergoing endovascular therapy (EVT), leading to a possible ‘weekend effect’. Research Question/Hypothesis: Are weekend admissions associated with differences in in-hospital outcomes among patients with AIS undergoing EVT compared with weekday admissions? Methods: We analyzed the National Inpatient Sample database to identify adults (≥18 years) hospitalized with a primary diagnosis for AIS (ICD-10-CM codes I63.0 – I63.9) between 2018 and 2020. Procedure codes were then used to identify hospitalizations that underwent EVT (ICD-10-PCS codes 03C[A-Z]3ZZ). The primary outcome was in-hospital mortality; secondary outcomes included length of stay (LOS), inflation-adjusted total hospital charges, mechanical ventilation use, intracranial hemorrhage (ICH), and favorable discharge. Using multivariable logistic and linear regression models adjusted for demographics, comorbidities, insurance, and hospital characteristics, we evaluated associations between weekend (versus weekday) admission and in-hospital outcomes. Results: Out of a total of 61,955 patients with AIS who underwent EVT (mean age: 69 years; males: 50%), 27.2% (n=16,850) were admitted on weekends and 72.8% (n=45,105) on weekdays. In-hospital mortality occurred in 12% (n=7,175) of patients, with no significant difference between weekend and weekday admissions (adjusted odds ratio [aORs], 0.99 (95% confidence interval [CI] 0.87–1.12; p=0.9). Similarly, weekend admission had no significant effect on LOS (β=-0.16 [95% CI, -0.52 – 0.19]; p=0.4) or total hospital charges (β=286 [95% CI, -6747 – 7320]; p>0.9) compared with weekday admission. In addition, no significant differences were observed for mechanical ventilation use (p=0.9), incidence of secondary ICH (p=0.4), and favorable discharge disposition (p=0.3) between patients admitted on weekends versus weekdays. Conclusions: No weekend effect on in-hospital outcomes and resource utilization was observed in patients with AIS undergoing EVT, suggesting consistent care quality and operational efficiency regardless of admission day.