Evidence map›Paper›PMID 25554369›Full record

ArticleThe American journal of medicine2015

Beta-blocker Use and 30-day All-cause Readmission in Medicare Beneficiaries with Systolic Heart Failure.

Vikas Bhatia, Navkaranbir S Bajaj, Kumar Sanam, Taimoor Hashim, Charity J Morgan, Sumanth D Prabhu, Gregg C Fonarow, Prakash Deedwania, Javed Butler, Peter Carson and 8 more

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

Article in The American journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
3.0field-weighted citation impact, top 8% 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

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.

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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

18 authors at 9 institutions in 2 countries.

Vikas BhatiaUniversity of Alabama at Birmingham, Birmingham, Ala; Veterans Affairs Medical Center, Birmingham, Ala. Electronic address: vikasbhatiamamc@gmail.com.
Navkaranbir S BajajUniversity of Alabama at Birmingham, Birmingham, Ala; Veterans Affairs Medical Center, Birmingham, Ala.
Kumar SanamUniversity of Alabama at Birmingham, Birmingham, Ala.
Taimoor HashimUniversity of Alabama at Birmingham, Birmingham, Ala.
Charity J MorganUniversity of Alabama at Birmingham, Birmingham, Ala.
Sumanth D PrabhuUniversity of Alabama at Birmingham, Birmingham, Ala; Veterans Affairs Medical Center, Birmingham, Ala.
Gregg C FonarowUniversity of California, Los Angeles.
Prakash DeedwaniaUniversity of California, San Francisco, Fresno.
Javed ButlerStony Brook University, Stony Brook, NY.
Peter CarsonVeterans Affairs Medical Center, Washington, DC.
Thomas E LoveCase Western Reserve University, Cleveland, Ohio.
Raya KheirbekVeterans Affairs Medical Center, Washington, DC.
Wilbert S AronowNew York Medical College, Valhalla.
Stefan D AnkerDepartment of Innovative Clinical Trials, University Medical Centre Göttingen, Göttingen, Germany.
Finn WaagsteinUniversity of Gothenburg, Gothenburg, Sweden.
Ross FletcherVeterans Affairs Medical Center, Washington, DC.
Richard M AllmanDepartment of Veterans Affairs, Geriatrics and Extended Care Services, Washington, DC.
Ali AhmedVeterans Affairs Medical Center, Washington, DC.
University of Alabama at Birmingham · USVeterans Health Administration · USCase Western Reserve University · USNew York Medical College · USOffice of Patient Care Services · USStony Brook University · USUniversity of California, Los Angeles · USUniversity of California, San Francisco · USUniversity of Gothenburg · SE

Funding

Heart failure, chronic kidney disease, and renin-angiotensin system inhibitionR01HL085561 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2006 to 2009
$1.5M
Neurohormonal Blockade and Outcomes in Diastolic Heart FailureR01HL097047 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2009 to 2010
$915k
Heart Failure and Beta-Blocker Use in Older AdultsK23AG019211 · NIA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AHMED, ALI · 2003 to 2006
$500k
NHLBI NIH HHS R01 HL085561NHLBI NIH HHS R01-HL085561NHLBI NIH HHS R01 HL097047NHLBI NIH HHS R01-HL097047NIA NIH HHS K23 AG019211
6 · The paper itself

Abstract

backgroundBeta-blockers improve outcomes in patients with systolic heart failure. However, it is unknown whether their initial negative inotropic effect may increase 30-day all-cause readmission, a target outcome for Medicare cost reduction and financial penalty for hospitals under the Affordable Care Act.

methodsOf the 3067 Medicare beneficiaries discharged alive from 106 Alabama hospitals (1998-2001) with a primary discharge diagnosis of heart failure and ejection fraction <45%, 2202 were not previously on beta-blocker therapy, of which 383 received new discharge prescriptions for beta-blockers. Propensity scores for beta-blocker use, estimated for each of the 2202 patients, were used to assemble a matched cohort of 380 pairs of patients receiving and not receiving beta-blockers who were balanced on 36 baseline characteristics (mean age 73 years, mean ejection fraction 27%, 45% women, 33% African American).

resultsBeta-blocker use was not associated with 30-day all-cause readmission (hazard ratio [HR] 0.87; 95% confidence interval [CI], 0.64-1.18) or heart failure readmission (HR 0.95; 95% CI, 0.57-1.58), but was significantly associated with lower 30-day all-cause mortality (HR 0.29; 95% CI, 0.12-0.73). During 4-year postdischarge, those in the beta-blocker group had lower mortality (HR 0.81; 95% CI, 0.67-0.98) and combined outcome of all-cause mortality or all-cause readmission (HR 0.87; 95% CI, 0.74-0.97), but not with all-cause readmission (HR 0.89; 95% CI, 0.76-1.04).

conclusionsAmong hospitalized older patients with systolic heart failure, discharge prescription of beta-blockers was associated with lower 30-day all-cause mortality and 4-year combined death or readmission outcomes without higher 30-day readmission.

Indexed as

MedicareAdrenergic beta-AntagonistsAgedAged, 80 and overCause of DeathConfidence IntervalsDose-Response Relationship, DrugDrug Administration ScheduleFemaleFollow-Up StudiesHeart Failure, SystolicHospital MortalityHumansKaplan-Meier EstimateMaleMiddle AgedAdrenergic beta-AntagonistsBeta-blockersHospitalizationOlder adultsReadmissionSystolic heart failure

Identifiers

PMID25554369
PMCPMC6756434
OpenAlexW2077166850

What OpenQuestion holds

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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.