Weekly variation of hospital admissions for stroke in Nis (Serbia)

Abstract 

Objectives

Weekly variability in stroke occurrence could be related to the change in behaviors of patients or medical personnel that occur during certain periods of the week. The aim of the present study was to examine the weekly variation in hospital admissions for stroke in Nis (Serbia), as well as to investigate how the demographic factors influenced these changes.

Patients and methods

The main data source for this study was the Nis Stroke Registry. During the study period (1996–2007) a total of 9675 stroke patients were registered. According to stroke subtypes, all registered patients were divided into three groups: patients with subarachnoid hemorrhage (SAH) (438 or 4.5%), patients with intracerebral hemorrhage (ICH) (1576 or 16.3%) and patients with ischemic stroke (IS) (6946 or 71.8%). Analyses were conducted separately for SAH, ICH and IS. Each stroke type was stratified by gender, age group and education level.

Results

We have showed that there is a significant weekly variability in the number of SAH (p=0.028) and IS (p<0.001) admissions, with the minimum number of admissions on Sundays (39.27 and 14.04% less than expected), and the maximum one on Tuesdays (21.46% more than expected) and Wednesdays (10.96% more than expected), respectively. We have also registered more SAH (p=0.015) and IS (p<0.001) admissions on weekdays than on weekend days.

Conclusion

Results of this hospital-based study confirm that there is a pattern in the variation of the number of stroke admissions on the weekly level. Reasons for the weekly variation of hospital admissions for stroke cannot be determined from the present study.

Keywords: Intracerebral hemorrhage, Subarachnoid hemorrhage, Ischemic stroke, Epidemiology, Weekly variability, Monte Carlo simulation