Observational studyJournal of general internal medicine2017
Vital Signs Are Still Vital: Instability on Discharge and the Risk of Post-Discharge Adverse Outcomes.
Observational study in Journal of general internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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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
30 citing papers in PubMed, 65 citations in OpenAlex.
- Patient safety in non-conveyance within prehospital emergency medical services: a register-based study.Internal and emergency medicine · 2026Article
- Continuous vital sign monitoring for predicting hospital length of stay: a feasibility study in chronic obstructive pulmonary disease and chronic heart failure patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Clinical Instability at Discharge and Post-Discharge Outcomes in Patients with Community-Acquired Pneumonia: An Observational Study.Journal of clinical medicine · 2025Article
- Audit-and-Feedback Utilizing Resident Consensus Standards Reduced Daily Labs.Journal of graduate medical education · 2025Article
- Clinical validation of non-contact vital signs in an emergency department setting.Frontiers in medical technology · 2025Article
- The optimal duration of continuous respiratory rate monitoring to predict in-hospital mortality within seven days of admission - A pilot study in a low resource setting.Resuscitation plus · 2024Article
- Agreement and comparative accuracy of instability criteria at discharge for predicting adverse events in patients with community-acquired pneumonia.BMJ open respiratory research · 2024Article
- Development and implementation of an artificial intelligence-enhanced care model to improve patient safety in hospital wards in Spain.Acute and critical care · 2024Article
- Predictability of adult patient medical emergency condition from triage vital signs and comorbidities: a single-center, observational study.BMC emergency medicine · 2024Observational
- Research trends in readiness for hospital discharge between 2002 and 2021: A bibliometric analysis.Nursing open · 2023Article
- Deviating vital signs in continuous monitoring prior to discharge and risk of readmission: an observational study.Internal and emergency medicine · 2023Observational
- National Trends in Vital Sign Abnormalities at Arrival to the Emergency Department.The western journal of emergency medicine · 2023Article
- Readmission Risk after COVID-19 Hospitalization: A Moderation Analysis by Vital Signs.Southern medical journal · 2022Article
- Observational
- Accuracy of Electronic Medical Record Follow-Up Data for Estimating the Survival Time of Patients With Cancer.JCO clinical cancer informatics · 2022Article
- Applying Hospital Readmissions to Oncology: A Square Peg in a Round Hole?JCO oncology practice · 2022Article
- Man vs. Machine: Comparing Physician vs. Electronic Health Record-Based Model Predictions for 30-Day Hospital Readmissions.Journal of general internal medicine · 2021Article
- Systems for recognition and response to deteriorating emergency department patients: a scoping review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Article
- A nurse-driven enhanced recovery after surgery (ERAS) nursing program for geriatric patients following lung surgery.Thoracic cancer · 2020Article
- Observational
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundVital sign instability on discharge could be a clinically objective means of assessing readiness and safety for discharge; however, the association between vital sign instability on discharge and post-hospital outcomes is unclear.
objectiveTo assess the association between vital sign instability at hospital discharge and post-discharge adverse outcomes.
designMulti-center observational cohort study using electronic health record data. Abnormalities in temperature, heart rate, blood pressure, respiratory rate, and oxygen saturation were assessed within 24 hours of discharge. We used logistic regression adjusted for predictors of 30-day death and readmission.
participantsAdults (≥18 years) with a hospitalization to any medicine service in 2009-2010 at six hospitals (safety-net, community, teaching, and non-teaching) in north Texas. MAIN MEASURES: Death or non-elective readmission within 30 days after discharge. KEY
resultsOf 32,835 individuals, 18.7 % were discharged with one or more vital sign instabilities. Overall, 12.8 % of individuals with no instabilities on discharge died or were readmitted, compared to 16.9 % with one instability, 21.2 % with two instabilities, and 26.0 % with three or more instabilities (p < 0.001). The presence of any (≥1) instability was associated with higher risk-adjusted odds of either death or readmission (AOR 1.36, 95 % CI 1.26-1.48), and was more strongly associated with death (AOR 2.31, 95 % CI 1.91-2.79). Individuals with three or more instabilities had nearly fourfold increased odds of death (AOR 3.91, 95 % CI 1.69-9.06) and increased odds of 30-day readmission (AOR 1.36, 95 % 0.81-2.30) compared to individuals with no instabilities. Having two or more vital sign instabilities at discharge had a positive predictive value of 22 % and positive likelihood ratio of 1.8 for 30-day death or readmission.
conclusionsVital sign instability on discharge is associated with increased risk-adjusted rates of 30-day mortality and readmission. These simple vital sign criteria could be used to assess safety for discharge, and to reduce 30-day mortality and readmissions.
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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.