Evidence map›Paper›PMID 27301933›Full record

Observational studyStroke2016

Majority of 30-Day Readmissions After Intracerebral Hemorrhage Are Related to Infections.

Aaron S Lord, Ariane Lewis, Barry Czeisler, Koto Ishida, Jose Torres, Hooman Kamel, Daniel Woo, Mitchell S V Elkind, Bernadette Boden-Albala

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 10% 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, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Development and validation of a job aid: Tool to reduce infections in home-based stroke.African journal of primary health care & family medicine · 2024
    Article
  12. Article
  13. Readmission Rates in Stroke Patients with and without Infections: Incidence and Risk Factors.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022
    Article
  14. Molecular Mechanisms of Neuroimmune Crosstalk in the Pathogenesis of Stroke.International journal of molecular sciences · 2021
    Review
  15. Article
  16. Article
  17. Observational
  18. Article
  19. Article
  20. Systemic inflammation in hemorrhagic strokes - A novel neurological sign and therapeutic target?Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2019
    Review
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

9 authors at 3 institutions in 1 country.

Aaron S LordFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.). aaron.lord@nyumc.org.
Ariane LewisFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Barry CzeislerFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Koto IshidaFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Jose TorresFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Hooman KamelFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Daniel WooFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Mitchell S V ElkindFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Bernadette Boden-AlbalaFrom the Department of Neurology, New York University School of Medicine (A.S.L., A.L., B.C., K.I., J.T., B.B.-A.); Department of Neurology, Weill Cornell Medical College, New York, NY (H.K.); Department of Neurology and Rehabilitation, University of Cincinnati College of Medicine, OH (D.W.); Departments of Neurology and Epidemiology, Columbia University, New York, NY (M.S.V.E.); and Division of Epidemiology, College of Global Public Health, New York University (B.B.-A.).
Columbia University · USCornell University · USUniversity of Cincinnati Medical Center · US

Funding

Project-005UL1TR001445 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BREDELLA, MIRIAM ANTOINETTE, HOCHMAN, JUDITH S · 2015 to 2025
$103.5M
Institutional Clinical and Translational Science AwardUL1TR000038 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI CRONSTEIN, BRUCE NEIL, HOCHMAN, JUDITH S · 2012 to 2014
$16.8M
Institutional Clinical and Translational Science AwardKL2TR000053 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI CRONSTEIN, BRUCE NEIL · 2012 to 2014
$899k
NCATS NIH HHS KL2 TR000053NCATS NIH HHS UL1 TR000038NCATS NIH HHS UL1 TR001445
6 · The paper itself

Abstract

background and purposeInfections are common after intracerebral hemorrhage, but little is known about the risk of serious infection requiring readmission after hospital discharge.

methodsTo determine if infections are prevalent in patients readmitted within 30 days of discharge, we performed a retrospective cohort study of patients discharged from nonfederal acute care hospitals in California with a primary diagnosis of intracerebral hemorrhage between 2006 and 2010. We excluded patients who died during the index admission, were discharged against medical advice, or were not California residents. Our main outcome was 30-day unplanned readmission with primary infection-related International Classification of Diseases, Ninth Revision, Clinical Modification code.

resultsThere were 24 540 index intracerebral hemorrhage visits from 2006 to 2010. Unplanned readmissions occurred in 14.5% (n=3550) of index patients. Of 3550 readmissions, 777 (22%) had an infection-related primary diagnosis code. When evaluating primary and all secondary diagnosis codes, infection was associated with 1826 (51%) of readmissions. Other common diagnoses associated with readmission included stroke-related codes (n=840, 23.7%) and aspiration pneumonitis (n=154, 4.3%). The most common infection-related primary diagnosis codes were septicemia (n=420, 11.8%), pneumonia (n=124, 3.5%), urinary tract infection (n=141, 4.0%), and gastrointestinal infection (n=42, 1.2%). Patients with a primary infection-related International Classification of Diseases, Ninth Revision, Clinical Modification code on readmission had higher in-hospital mortality compared with other types of readmission (15.6% versus 8.0%, P<0.001). After controlling for other predictors of mortality, primary infection-related readmissions remained associated with in-hospital mortality (relative risk, 1.7; 95% confidence interval, 1.3-2.2).

conclusionsInfections are associated with a majority of 30-day readmissions after intracerebral hemorrhage and increased mortality. Efforts should be made to reduce infection-related complications after hospital discharge.

Indexed as

Patient ReadmissionAgedCaliforniaCerebral HemorrhageFemaleHospital MortalityHumansMaleMiddle AgedPatient DischargePneumoniaPneumonia, AspirationRetrospective StudiesRisk FactorsSepsisStrokeepidemiologyhealth services researchpneumoniastrokeurinary tract infection

Identifiers

PMID27301933
PMCPMC4927367
OpenAlexW2422557043

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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.