ArticleAmerican journal of respiratory and critical care medicine2012
The implications of long-term acute care hospital transfer practices for measures of in-hospital mortality and length of stay.
Article in American journal of respiratory and critical care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled 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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Incidence and risk factors of new persistent opioid use after surgery and trauma: A systematic review.BMC surgery · 2024Pooled it
- Laparoscopic versus robotic right colectomy with extra-corporeal or intra-corporeal anastomosis: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2021Pooled it
- Two decades of mortality trends among patients with severe sepsis: a comparative meta-analysis*.Critical care medicine · 2014Pooled it
- Changes in hospital mortality for United States intensive care unit admissions from 1988 to 2012.Critical care (London, England) · 2013Trial
- Assessment of the effectiveness of protein in critical illness: the role of statistical shortcomings in explaining discrepancies between observational studies and randomized controlled trials.Critical care (London, England) · 2026Review
- Psychosocial factors influencing the outcomes after major anatomical lung resections: a retrospective analysis of prospectively collected data.Journal of thoracic disease · 2025Article
- In-Hospital vs 30-Day Sepsis Mortality at US Safety-Net and Non-Safety-Net Hospitals.JAMA network open · 2024Article
- Days out of Institution after Tracheostomy and Gastrostomy Placement in Critically Ill Older Adults.Annals of the American Thoracic Society · 2022Article
- Hospital-Free Days: A Pragmatic and Patient-centered Outcome for Trials among Critically and Seriously Ill Patients.American journal of respiratory and critical care medicine · 2021Article
- Availability of Palliative Care in Long-Term Acute Care Hospitals.Journal of the American Medical Directors Association · 2021Article
- Financial Estimation of the Uncertainty in Medicine Using Present Value of Medical Fees and a Mortality Risk Prediction Model: a Retrospective Cohort Study.Journal of medical systems · 2021Article
- An administrative model for benchmarking hospitals on their 30-day sepsis mortality.BMC health services research · 2019Article
- Comparison of Care Patterns and Rehospitalizations for Mechanically Ventilated Patients in New York and Ontario.Annals of the American Thoracic Society · 2019Article
- Long-Term Acute Care Hospital Use of Non-Mechanically Ventilated Hospitalized Older Adults.Journal of the American Geriatrics Society · 2018Observational
- Overweight or obese BMI is associated with earlier, but not later survival after common acute illnesses.BMC geriatrics · 2018Observational
- Intensive Care Unit Admission and Survival among Older Patients with Chronic Obstructive Pulmonary Disease, Heart Failure, or Myocardial Infarction.Annals of the American Thoracic Society · 2017Article
- Association Between Noninvasive Ventilation and Mortality Among Older Patients With Pneumonia.Critical care medicine · 2017Article
- Deaths from necrotizing fasciitis in the United States, 2003-2013.Epidemiology and infection · 2016Article
- Necrotizing Fasciitis Among Patients With Liver Cirrhosis in Texas, 2001 - 2010: A Population-Based Cohort Study.Journal of clinical medicine research · 2016Article
- Association of Do-Not-Resuscitate Orders and Hospital Mortality Rate Among Patients With Pneumonia.JAMA internal medicine · 2016Article
Corrections and comments
- Commented on by
Authors and funding
4 authors.
Funding
Abstract
rationaleThe National Quality Forum recently endorsed in-hospital mortality and intensive care unit length of stay (LOS) as quality indicators for patients in the intensive care unit. These measures may be affected by transferring patients to long-term acute care hospitals (LTACs).
objectivesTo quantify the implications of LTAC transfer practices on variation in mortality index and LOS index for patients in academic medical centers.
methodsWe used a cross-sectional study design using data reported to the University HealthSystem Consortium from 2008-2009. Data were from patients who were mechanically ventilated for more than 96 hours. MEASUREMENTS AND MAIN
resultsUsing linear regression, we measured the association between mortality index and LTAC transfer rate, with the hospital as the unit of analysis. Similar analyses were conducted for LOS index and cost index. A total of 137 hospitals were analyzed, averaging 534 transfers to LTAC per hospital during the study period. Mean±SD in-hospital mortality was 24±6.4%, and observed LOS was 30.4±8.2 days. The mean LTAC transfer rate was 15.7±13.7%. Linear regression demonstrated a significant correlation between transfer rate and mortality index (R2=0.14; P<0.0001) and LOS index (R2=0.43; P<0.0001).
conclusionsLTAC hospital transfer rate has a significant impact on reported mortality and LOS indices for patients requiring prolonged acute mechanical ventilation. This is an example of factors unrelated to quality of medical care or illness severity that must be considered when interpreting mortality and LOS as quality indicators.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.