Evidence map›Paper›PMID 20586586›Full record

ArticlePrehospital emergency care

Injury hospitalization as a marker for emergency medical services use in elderly patients.

Ross J Fleischman, K John McConnell, Annette L Adams, Jerris R Hedges, Craig D Newgard

Abstract read
In one paragraph

Article in Prehospital emergency care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Functional Decline Predicts Emergency Department Use in Veterans With Dementia.American journal of Alzheimer's disease and other dementias · 2014
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ross J FleischmanThe Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 97239, USA. fleischr@ohsu.edu
K John McConnell
Annette L Adams
Jerris R Hedges
Craig D Newgard

Funding

OREGON CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024140 · NCRR · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2006 to 2011
$61.1M
RESEARCH DESIGN AND BIOSTATISTICS COREU54MD007584 · NIMHD · UNIVERSITY OF HAWAII AT MANOA · PI MOKUAU, NOREEN, SHIRAMIZU, BRUCE T · 2012 to 2018
$21.1M
NCRR NIH HHS UL1 RR024140NIMHD NIH HHS U54 MD007584
6 · The paper itself

Abstract

backgroundThe elderly utilize emergency medical services (EMS) at a higher rate than younger patients, yet little is known about the influence of injury on subsequent EMS utilization and costs.

objectiveTo assess injury hospitalization as a potential marker for subsequent EMS utilization and costs by Medicare patients.

methodsThis observational study analyzed a retrospective cohort of all Medicare patients (> or = 67 years old) with an International Classification of Diseases, Ninth Revision (ICD-9) injury diagnosis admitted to 125 Oregon and Washington hospitals during 2001 and 2002 who survived to hospital discharge. The numbers of EMS transports and the total EMS costs were compared one year before and one year following the index hospitalization.

resultsThere were 30,655 injured elders in our cohort. Their median ICD-9-based injury severity score was 0.97, with 4.1% meeting a definition of serious injury and 37% having hip fractures. The mean (range) numbers of EMS transports before and after the injury were 0.5 (0-45) and 0.9 (0-56), for an unadjusted incidence rate ratio (IRR) of 1.7 (95% confidence interval [CI] 1.7-1.8). The increase in EMS utilization following an injury hospitalization was even greater after adjusting for risk period and other model predictors (IRR 2.4, 95% CI 2.3-2.5). Annual mean EMS costs rose 74% following the injury hospitalization, from $211 to $367 per person. The greatest increase was in nonemergent EMS use, accounting for 67% of the increase in the number of uses. Institutionalization in a skilled nursing or rehabilitation facility either before or after injury was strongly associated with the need for EMS care.

conclusionAn injury hospitalization in the elderly serves as a sentinel marker for an abrupt increase in EMS utilization and costs, even after accounting for confounders.

Indexed as

Wounds and InjuriesAgedAged, 80 and overCohort StudiesEmergency Medical ServicesFemaleHealth Care CostsHospitalizationHumansMaleMedicareOregonRetrospective StudiesUnited StatesWashington

Identifiers

PMID20586586
PMCPMC2992380

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.