[Effect of different working time on the prognosis of ischemic stroke patients undergoing intravenous thrombolysis]

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2019 May 25;48(3):267-274. doi: 10.3785/j.issn.1008-9292.2019.06.06.
[Article in Chinese]

Abstract

Objective: To investigate the effect of working time on the prognosis of patients with ischemic stroke undergoing intravenous thrombolysis.

Methods: Clinical data of 3050 patients with ischemic stroke received intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and September 2018 were retrospective analyzed. Whole day of Saturday and Sunday were defined as weekend; whole day of Monday to Friday were defined as weekdays; Monday to Friday 8:00-17:00 were defined as daytime of weekdays; Monday to Friday 17:01-07:59 on next day were defined as nights of weekdays; unconventional working time were defined as weekend and nights of weekdays. Good outcome was defined as mRS 0-2 at 3 months. Univariate analyses of baseline and prognostic variables in group of weekend and weekdays, nights of weekdays and daytime of weekdays, unconventional working time and daytime of weekdays were performed. Binary logistic regression was used to investigate whether weekend, nights of weekdays and unconventional working time were independent predicting factors of outcome after intravenous thrombolysis, respectively.

Results: There was no difference in 7-day mortality, 3-month mortality and good outcome at 3-month between weekend group and weekdays group, nights of weekdays group and daytime of weekdays group, unconventional working time group and daytime of weekdays group (all P>0.05). Binary logistic regression results showed that weekends, nights of weekdays and unconventional working time were not independent predicting factors for outcome after intravenous thrombolysis (all P>0.05).

Conclusions: The working time has not affected the outcomes of patients with ischemic stroke undergoing intravenous thrombolysis in studied hospitals of Zhejiang province.

目的: 比较不同工作时间段就诊并接受静脉溶栓治疗的缺血性脑卒中患者预后是否存在差异。

方法: 回顾性分析浙江省71家医院2017年6月至2018年9月接受静脉溶栓治疗的3050例缺血性脑卒中患者的资料。比较周末组与非周末组、工作日夜间组与白天组、非常规工作时间组与常规工作时间组的基线资料及预后,采用二元Logistic回归分析法研究周末、工作日夜间、非常规工作时间是否为静脉溶栓患者预后的独立影响因素。

结果: 周末组与非周末组、工作日夜间组与白天组、非常规工作时间组与常规工作时间组患者7 d病死率、3个月病死率和3个月预后良好的比例差异均无统计学意义(均 P>0.05)。二元Logistic回归分析结果显示,周末、工作日夜间、非常规工作时间均不是缺血性脑卒中患者静脉溶栓治疗3个月预后的独立影响因素(均 P>0.05)。

结论: 浙江省周末与非周末、工作日夜间与白天、非常规工作时间与常规工作时间接受静脉溶栓的缺血性脑卒中患者的预后无差异。

MeSH terms

  • Brain Ischemia* / drug therapy
  • Humans
  • Prognosis
  • Retrospective Studies
  • Stroke* / drug therapy
  • Thrombolytic Therapy*
  • Time Factors

Grants and funding

浙江省重点研发计划(2018C04011);国家自然科学基金(81622017);国家重点研发计划(2016YFC1301503);中国中青年研究基金("V.G"项目)(2017-CCA-VG-004)