Evidence map›Paper›PMID 28214235›Full record

ArticleJournal of the American Medical Directors Association2017

Effects of Postacute Settings on Readmission Rates and Reasons for Readmission Following Total Knee Arthroplasty.

Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Hospital volume-outcome relationship in total knee arthroplasty: a systematic review and dose-response meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
    Pooled it
  3. Article
  4. Review
  5. Article
  6. Impact of Post-Discharge Disposition on Risk and Causes of Readmission Following Liver and Pancreas Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018
    Article
  7. 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.

Rodney Laine WelshOccupational Therapy, University of Texas Medical Branch, Galveston, TX; Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX. Electronic address: rlwelsh@utmb.edu.
James E GrahamRehabilitation Sciences, University of Texas Medical Branch, Galveston, TX.
Amol M KarmarkarRehabilitation Sciences, University of Texas Medical Branch, Galveston, TX.
Natalie E LelandChan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry and Davis School of Gerontology, University of Southern California, Los Angeles, CA; Department of Health Services, Policy, and Practice, Brown University, Providence, Rhode Island.
Jacques G BaillargeonPreventative Medicine and Community Health, University of Texas Medical Branch, Galveston, TX.
Dana L WildPhysical Therapy, University of Texas Medical Branch, Galveston, TX.
Kenneth J OttenbacherRehabilitation Sciences, University of Texas Medical Branch, Galveston, TX.

Funding

Technique Development CoreP2CHD065702 · NICHD · UNIVERSITY OF TEXAS MED BR GALVESTON · PI GRAHAM, JAMES E. · 2015 to 2019
$5.2M
Center for Rehabilitation Research Using Large DatasetsR24HD065702 · NICHD · UNIVERSITY OF TEXAS MED BR GALVESTON · PI OTTENBACHER, KENNETH J. · 2010 to 2014
$4.0M
Hospital Readmission and Inpatient Medical RehabilitationR01HD069443 · NICHD · UNIVERSITY OF TEXAS MED BR GALVESTON · PI OTTENBACHER, KENNETH J. · 2012 to 2015
$927k
Comparing Access and Effectiveness of Post-Acute Care Settings Among Medicare BeneficiariesK01HD086290 · NICHD · VIRGINIA COMMONWEALTH UNIVERSITY · PI KARMARKAR, AMOL · 2016 to 2020
$636k
Identifying Patient-Centered Fall Prevention Care Processes in Hip Fracture RehabilitationK01HS022907 · AHRQ · UNIVERSITY OF SOUTHERN CALIFORNIA · PI LELAND, NATALIE ELIZABETH · 2015 to 2017
$432k
AHRQ HHS K01 HS022907NICHD NIH HHS K01 HD086290NICHD NIH HHS P2C HD065702NICHD NIH HHS R01 HD069443NICHD NIH HHS R24 HD065702
6 · The paper itself

Abstract

objectivesExamine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults.

designSecondary analyses of 100% Medicare (inpatient) claims files.

settingAcute hospitals across the United States.

participantsMedicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031). MEASUREMENTS: The outcome measure was unplanned readmissions at 30, 60, and 90 days. The independent variable of interest was postacute discharge setting: inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), or community. Covariates included demographic, clinical, and facility-level factors. The top 10 reasons for readmission were tabulated for each discharge setting across the 3 consecutive 30-day time periods.

resultsA total of 32,226 patients (5.3%) were re-admitted within 30 days. Compared with community discharge, patients discharged to IRF and SNF had 44% and 40% higher odds of 30-day readmission, respectively. IRF and SNF discharge settings were also associated with 48% and 45% higher odds of 90-day readmission, respectively, compared with community discharge. The largest increase in readmission rates occurred within the first 30 days of hospital discharge for each discharge setting. From 1 to 30 days, postoperative and post-traumatic infections were among the top causes for readmission in all 3 discharge settings. From 31 to 60 days, postoperative or traumatic infections remained in the top 5-7 reasons for readmission in all settings, but they were not in the top 10 at 61 to 90 days.

conclusionsPatients discharged to either SNF or IRF, in comparison with those discharged to the community, had greater likelihood of readmission within 30 and 90 days. The reasons for readmission were relatively consistent across discharge settings and time periods. These findings provide new information relevant to the delivery of postacute care to older adults following TKA.

Indexed as

Arthroplasty, Replacement, KneePatient ReadmissionRehabilitation CentersSkilled Nursing FacilitiesAgedAged, 80 and overFemaleHumansInsurance Claim ReviewMaleMedicareUnited Statesdischarge settingHospital readmissionMedicaretotal knee replacement

Identifiers

PMID28214235
PMCPMC5366260

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Registered trials

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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.