Evidence map›Paper›PMID 27256009›Full record

ArticleJournal of hospital medicine2016

Real-time automated clinical deterioration alerts predict thirty-day hospital readmission.

Scott T Micek, Maanasi Samant, Thomas Bailey, Yixin Chen, Chenyang Lu, Kevin Heard, Marin H Kollef

Open access · greenAbstract read
In one paragraph

Article in Journal of hospital medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 37% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
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

7 authors at 3 institutions in 1 country.

Scott T MicekDepartment of Pharmacy Practice, St. Louis College of Pharmacy, St. Louis, Missouri.
Maanasi SamantDepartment of Internal Medicine, Washington University, St. Louis, Missouri.
Thomas BaileyDivision of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri.
Yixin ChenSchool of Engineering and Applied Sciences, Washington University in St. Louis, St. Louis, Missouri.
Chenyang LuSchool of Engineering and Applied Sciences, Washington University in St. Louis, St. Louis, Missouri.
Kevin HeardCenter for Clinical Excellence, BJC HealthCare, St. Louis, Missouri.
Marin H KollefDivision of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri. mkollef@dom.wustl.edu.
Washington University in St. Louis · USBJC HealthCare · USUniversity of Health Sciences and Pharmacy · US

Funding

Washington University Institute of Clinical and Translational Sciences (UL1)UL1RR024992 · NCRR · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2007 to 2011
$45.4M
Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
NCATS NIH HHS UL1 TR000448NCRR NIH HHS UL1 RR024992
6 · The paper itself

Abstract

introductionClinical deterioration alerts (CDAs) are increasingly employed to identify deteriorating patients.

methodsWe performed a retrospective study to determine whether CDAs predict 30-day readmission. Patients admitted to 8 general medicine units were assessed for all-cause 30-day readmission.

resultsAmong 3015 patients, 567 (18.8%) were readmitted within 30 days. Patients triggering a CDA (n = 1141; 34.4%) were more likely to have a 30-day readmission (23.6% vs 15.9%; P < 0.001). Logistic regression identified triggering of a CDA to be independently associated with 30-day readmission (odds ratio [OR]: 1.40; 95% confidence interval [CI]: 1.26-1.55; P = 0.001). Other predictors were: an emergency department visit in the previous 6 months (OR: 1.23; 95% CI:, 1.20-1.26; P < 0.001), increasing age (OR: 1.01; 95% CI: 1.01-1.02; P = 0.003), presence of connective tissue disease (OR: 1.63; 95% CI: 1.34-1.98; P = 0.012), diabetes mellitus with end-organ complications (OR: 1.23; 95% CI: 1.13-1.33; P = 0.010), chronic renal disease (OR: 1.16; 95% CI: 1.08-1.24; P = 0.034), cirrhosis (OR: 1.25; 95% CI: 1.17-1.33; P < 0.001), and metastatic cancer (OR: 1.12; 95% CI: 1.08-1.17; P = 0.002). Addition of the CDA to the other predictors added only modest incremental value for the prediction of hospital readmission.

conclusionsReadily identifiable clinical variables can be identified that predict 30-day readmission. It may be important to include these variables in existing prediction tools if pay for performance and across-institution comparisons are to be "fair" to institutions that care for more seriously ill patients. Journal of Hospital Medicine 2016;11:768-772. © 2016 Society of Hospital Medicine.

Indexed as

AlgorithmsClinical DeteriorationModels, StatisticalAge FactorsFemaleHospitalsHumansMaleMiddle AgedPatient ReadmissionRetrospective StudiesRisk Factors

Identifiers

PMID27256009
PMCPMC5309927
OpenAlexW2411683173

What OpenQuestion holds

Textmetadata
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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.