ArticleMedical care2015
Nonelective Rehospitalizations and Postdischarge Mortality: Predictive Models Suitable for Use in Real Time.
Article in Medical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
What it found
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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
41 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Use of electronic medical records in development and validation of risk prediction models of hospital readmission: systematic review.BMJ (Clinical research ed.) · 2020Pooled it
- Statistical Modeling and Aggregate-Weighted Scoring Systems in Prediction of Mortality and ICU Transfer: A Systematic Review.Journal of hospital medicine · 2019Pooled it
- Utility of models to predict 28-day or 30-day unplanned hospital readmissions: an updated systematic review.BMJ open · 2016Pooled it
- Impact of emergency physician-provided patient education about alternative care venues.The American journal of managed care · 2018Trial
- Expanding care coordination in an integrated health system through causal machine learning.NPJ digital medicine · 2025Article
- Effects of the National Institutes of Health Stroke Scale and Modified Rankin Scale on Predictive Models of 30-Day Nonelective Readmission and Mortality After Ischemic Stroke: Cohort Study.JMIR medical informatics · 2025Article
- Emergency Department Triage Accuracy and Delays in Care for High-Risk Conditions.JAMA network open · 2025Article
- Prediction of 1 and 2 week nonelective hospitalization and sepsis hospitalization risk in adults.NPJ digital medicine · 2025Article
- Pilot trial of an electronic decision support to improve care for emergency department patients with acute heart failure.ESC heart failure · 2024Article
- Article
- Automated analysis of unstructured clinical assessments improves emergency department triage performance: A retrospective deep learning analysis.Journal of the American College of Emergency Physicians open · 2023Article
- Evaluation of the Emergency Severity Index in US Emergency Departments for the Rate of Mistriage.JAMA network open · 2023Article
- Exploratory analysis of novel electronic health record variables for quantification of healthcare delivery strain, prediction of mortality, and prediction of imminent discharge.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Evaluation of Incident 7-Day Infection and Sepsis Hospitalizations in an Integrated Health System.Annals of the American Thoracic Society · 2022Article
- Prospective evaluation of social risks, physical function, and cognitive function in prediction of non-elective rehospitalization and post-discharge mortality.BMC health services research · 2022Article
- Evaluation of Outcomes Following Hospital-Wide Implementation of a Subcutaneous Insulin Protocol for Diabetic Ketoacidosis.JAMA network open · 2022Article
- Evaluation of an intervention targeted with predictive analytics to prevent readmissions in an integrated health system: observational study.BMJ (Clinical research ed.) · 2021Observational
- Attitudes of Patients and Health Professionals Regarding Screening Algorithms: Qualitative Study.JMIR formative research · 2021Article
- Article
- Outcomes among acute heart failure emergency department patients by preserved vs. reduced ejection fraction.ESC heart failure · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundHospital discharge planning has been hampered by the lack of predictive models.
objectiveTo develop predictive models for nonelective rehospitalization and postdischarge mortality suitable for use in commercially available electronic medical records (EMRs).
designRetrospective cohort study using split validation.
settingIntegrated health care delivery system serving 3.9 million members.
participantsA total of 360,036 surviving adults who experienced 609,393 overnight hospitalizations at 21 hospitals between June 1, 2010 and December 31, 2013.
main outcome measureA composite outcome (nonelective rehospitalization and/or death within 7 or 30 days of discharge).
resultsNonelective rehospitalization rates at 7 and 30 days were 5.8% and 12.4%; mortality rates were 1.3% and 3.7%; and composite outcome rates were 6.3% and 14.9%, respectively. Using data from a comprehensive EMR, we developed 4 models that can generate risk estimates for risk of the combined outcome within 7 or 30 days, either at the time of admission or at 8 AM on the day of discharge. The best was the 30-day discharge day model, which had a c-statistic of 0.756 (95% confidence interval, 0.754-0.756) and a Nagelkerke pseudo-R of 0.174 (0.171-0.178) in the validation dataset. The most important predictors-a composite acute physiology score and end of life care directives-accounted for 54% of the predictive ability of the 30-day model. Incorporation of diagnoses (not reliably available for real-time use) did not improve model performance.
conclusionsIt is possible to develop robust predictive models, suitable for use in real time with commercially available EMRs, for nonelective rehospitalization and postdischarge mortality.
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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.