Evidence map›Paper›PMID 26396202›Full record

ArticleJournal of the American Heart Association2015

Post-Acute Care Data for Predicting Readmission After Ischemic Stroke: A Nationwide Cohort Analysis Using the Minimum Data Set.

Corey R Fehnel, Yoojin Lee, Linda C Wendell, Bradford B Thompson, N Stevenson Potter, Vincent Mor

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 5 pooled it
2.4field-weighted citation impact, top 11% 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, 5 syntheses or guidelines pooled it, 52 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

6 authors at 2 institutions in 1 country.

Corey R FehnelDivision of Neurocritical Care, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (C.R.F., L.C.W., B.B.T., S.P.).
Yoojin LeeDepartment of Health Services, Policy & Practice, Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI (Y.L., V.M.).
Linda C WendellDivision of Neurocritical Care, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (C.R.F., L.C.W., B.B.T., S.P.).
Bradford B ThompsonDivision of Neurocritical Care, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (C.R.F., L.C.W., B.B.T., S.P.).
N Stevenson PotterDivision of Neurocritical Care, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI (C.R.F., L.C.W., B.B.T., S.P.).
Vincent MorDepartment of Health Services, Policy & Practice, Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI (Y.L., V.M.).
Brown University · USRhode Island Hospital · US

Funding

VARIATIONS IN LIFE'S FINAL CHAPTERP01AG027296 · NIA · BROWN UNIVERSITY · PI AMAL N. TRIVEDI, Kali St. Marie Thomas · 2007 to 2026
$38.9M
NIA NIH HHS P01 AG027296
6 · The paper itself

Abstract

backgroundReducing hospital readmissions is a key component of reforms for stroke care. Current readmission prediction models lack accuracy and are limited by data being from only acute hospitalizations. We hypothesized that patient-level factors from a nationwide post-acute care database would improve prediction modeling. METHODS AND

resultsMedicare inpatient claims for the year 2008 that used International Classification of Diseases, Ninth Revision codes were used to identify ischemic stroke patients older than age 65. Unique individuals were linked to comprehensive post-acute care assessments through use of the Minimum Data Set (MDS). Logistic regression was used to construct risk-adjusted readmission models. Covariates were derived from MDS variables. Among 39 178 patients directly admitted to nursing homes after hospitalization due to acute stroke, there were 29 338 (75%) with complete MDS assessments. Crude rates of readmission and death at 30 days were 8448 (21%) and 2791 (7%), respectively. Risk-adjusted models identified multiple independent predictors of all-cause 30-day readmission. Model performance of the readmission model using MDS data had a c-statistic of 0.65 (95% CI 0.64 to 0.66). Higher levels of social engagement, a marker of nursing home quality, were associated with progressively lower odds of readmission (odds ratio 0.71, 95% CI 0.55 to 0.92).

conclusionsIndividual clinical characteristics from the post-acute care setting resulted in only modest improvement in the c-statistic relative to previous models that used only Medicare Part A data. Individual-level characteristics do not sufficiently account for the risk of acute hospital readmission.

Indexed as

Nursing HomesPatient ReadmissionAgedAged, 80 and overBrain IschemiaChi-Square DistributionDatabases, FactualFemaleHealth Services ResearchHumansLogistic ModelsMaleMedicare Part AOdds RatioPatient DischargeQuality Indicators, Health Carehealth care policyhealth services researchischemic strokeoutcomesreadmission

Identifiers

PMID26396202
PMCPMC4599502
OpenAlexW2106540507

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.