Does off-hour presentation increase in-hospital case fatality in stroke admissions?
Off-hour presentation for stroke is associated with a small to moderate increase in in-hospital mortality, representing a potential target for quality improvement.
Off-hour presentation was associated with an increased risk of dying in-hospital, although the absolute effect was small for ischemic stroke admissions (0.6% difference; number needed to harm=166) and moderate for hemorrhagic stroke (3.1% difference; number needed to harm=32). Reducing the disparity in hospital-based outcomes for admissions that present during off-hours represents a potential target for quality improvement efforts, although evidence of differences in the quality of care by time of presentation was lacking.
Reeves et al. (Fri,) studied this question.