Evidence map›Paper›PMID 25357165›Full record

ArticleChest2015

Effect of hospital use of oral nutritional supplementation on length of stay, hospital cost, and 30-day readmissions among Medicare patients with COPD.

Julia Thornton Snider, Anupam B Jena, Mark T Linthicum, Refaat A Hegazi, Jamie S Partridge, Chris LaVallee, Darius N Lakdawalla, Paul E Wischmeyer

Open access · bronzeAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
6.3field-weighted citation impact, top 3% of its field
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

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.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.

  1. Pooled it
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  4. A Proposed Checklist for Optimizing COPD Patient Discharge Processes in Italian Internal Medicine Wards.International journal of chronic obstructive pulmonary disease · 2026
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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

8 authors at 4 institutions in 1 country.

Julia Thornton SniderPrecision Health Economics, Los Angeles, CA.
Anupam B JenaDepartment of Health Care Policy, Harvard Medical School, Boston, MA; University of Colorado School of Medicine, Aurora, CO. Electronic address: jena@hcp.med.harvard.edu.
Mark T LinthicumPrecision Health Economics, Los Angeles, CA.
Refaat A HegaziAbbott Nutrition, Columbus, OH.
Jamie S PartridgeAbbott Nutrition, Columbus, OH.
Chris LaValleePrecision Health Economics, Los Angeles, CA.
Darius N LakdawallaLeonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA.
Paul E WischmeyerLeonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA.
University of Southern California · USAbbott Nutrition (United States)Abbott (United States) · USHarvard University · US

Funding

Mechanism of Heat Shock Protein Induction by GlutamineR01GM078312 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI WISCHMEYER, PAUL E · 2008 to 2012
$1.3M
Supplemental Parenteral Nutrition to Reduce Death in Malnourished ICU PatientsR34HL109369 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI HEYLAND, DAREN KEITH, WISCHMEYER, PAUL E · 2012 to 2014
$568k
NHLBI NIH HHS R34 HL109369NIGMS NIH HHS R01 GM078312
6 · The paper itself

Abstract

backgroundCOPD is a leading cause of death and disability in the United States. Patients with COPD are at a high risk of nutritional deficiency, which is associated with declines in respiratory function, lean body mass and strength, and immune function. Although oral nutritional supplementation (ONS) has been associated with improvements in some of these domains, the impact of hospital ONS on readmission risk, length of stay (LOS), and cost among hospitalized patients is unknown.

methodsUsing the Premier Research Database, we first identified Medicare patients aged ≥ 65 years hospitalized with a primary diagnosis of COPD. We then identified hospitalizations in which ONS was provided, and used propensity-score matching to compare LOS, hospitalization cost, and 30-day readmission rates in a one-to-one matched sample of ONS and non-ONS hospitalizations. To further address selection bias among patients prescribed ONS, we also used instrumental variables analysis to study the association of ONS with study outcomes. Model covariates included patient and provider characteristics and a time trend.

resultsOut of 10,322 ONS hospitalizations and 368,097 non-ONS hospitalizations, a one-to-one matched sample was created (N = 14,326). In unadjusted comparisons in the matched sample, ONS use was associated with longer LOS (8.7 days vs 6.9 days, P < .0001), higher hospitalization cost ($14,223 vs $9,340, P < .0001), and lower readmission rates (24.8% vs 26.6%, P = .0116). However, in instrumental variables analysis, ONS use was associated with a 1.9-day (21.5%) decrease in LOS, from 8.8 to 6.9 days (P < .01); a hospitalization cost reduction of $1,570 (12.5%), from $12,523 to $10,953 (P < .01); and a 13.1% decrease in probability of 30-day readmission, from 0.34 to 0.29 (P < .01).

conclusionsONS may be associated with reduced LOS, hospitalization cost, and readmission risk in hospitalized Medicare patients with COPD.

Indexed as

Dietary SupplementsInpatientsAdministration, OralAgedAged, 80 and overFemaleHospital CostsHospital RecordsHumansLength of StayMaleMedicareNutritional StatusOutcome Assessment, Health CarePatient ReadmissionPulmonary Disease, Chronic Obstructive

Identifiers

PMID25357165
PMCPMC4451705
OpenAlexW1974222290

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.