ArticleJournal of neurosurgical sciences2018
Readmission after spinal cord injury: analysis of an institutional cohort of 795 patients.
Article in Journal of neurosurgical sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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.
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Who cites it
6 citing papers in PubMed, 14 citations in OpenAlex.
- Effects of App-Based Transitional Care on the Self-Efficacy and Quality of Life of Patients With Spinal Cord Injury in China: Randomized Controlled Trial.JMIR mHealth and uHealth · 2021Trial
- Brief Review: Racial and Ethnic Disparities in Cardiovascular Care with a Focus on Congenital Heart Disease and Precision Medicine.Current atherosclerosis reports · 2023Review
- Weekend Admission Increases Risk of Readmissions Following Elective Cervical Spinal Fusion.Neurospine · 2023Article
- Health Care Utilization and Cost Associated With Urinary Tract Infections in a Privately Insured Spinal Cord Injury Population.Topics in spinal cord injury rehabilitation · 2023Article
- Factors associated with multiple hospital readmissions for individuals with spinal cord injury.Commonhealth (Philadelphia, Pa.) · 2020Article
- Functional status predicts acute care readmission in the traumatic spinal cord injury population.The journal of spinal cord medicine · 2019Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRecent studies in other fields have suggested that healthcare on the weekend may have worse outcomes. In particular, patients with stroke and acute cardiovascular events have shown worse outcomes with weekend treatment. It is unclear whether this extends to patients with spinal cord injury. This study was designed to evaluate factors for readmission after index hospitalization for spinal cord injury.
methodsA total of 795 consecutive patients over an 11-year period were analyzed. After excluding patients with chronic spinal cord injury and surgical care at an outside hospital, 745 patients remained. The primary outcome measure evaluated was 30-day readmission. Secondary measures include perioperative complications, readmission rate when discharged on the weekend, and the effect of race and insurance status on readmission rate. Univariate and multivariate analysis were utilized to evaluate the covariates collected. The χ2 test, Fisher's exact test, and linear and logistic regression methods were utilized for statistical analysis.
resultsA total of 745 patients were analyzed after exclusions. Payer status did not affect length of stay, ICU length of stay, or perioperative complications. Neither weekend admission nor weekend operation affected length of stay, ICU length of stay, or readmission by 30 days. Patients undergoing weekend surgical treatment had lower perioperative complication rates (2.2% vs. 6.5% on weekday, P<0.01). Discharge on the weekend was associated with a significantly lower rate of readmission by 30 days (OR=0.07, 95% CI: 0.009-0.525, P<0.005). Payer status was associated with 30-day readmission (P<0.005). Patients with Medicare (20.8%) and Medicaid (20.1%) showed higher rates of readmission than patients with other payers. 21.1% of African-American patients were readmitted, versus 10.2% of other patients (Odds ratio: 2.2, 95% confidence interval 1.36-3.27, P<0.001). Correcting for payer status lessened but did not eliminate the effect of race on readmission.
conclusionsWeekend admission did not increase perioperative complications or hospital length of stay. After discharge, patients with Medicaid and Medicare show higher rates of 30-day readmission, as do African-American patients. The effect of race on readmission is multifactorial, and may partially explained by the increased rate of Medicaid coverage in African-Americans in our institutions catchment area.
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