Evidence map›Paper›PMID 28794121›Full record

ArticleCirculation. Cardiovascular quality and outcomes2017

Changes in Primary Noncardiac Diagnoses Over Time Among Elderly Cardiac Intensive Care Unit Patients in the United States.

Shashank S Sinha, Michael W Sjoding, Devraj Sukul, Hallie C Prescott, Theodore J Iwashyna, Hitinder S Gurm, Colin R Cooke, Brahmajee K Nallamothu

Abstract readComparative Study
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 1 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

61 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Cardiogenic Shock and the Role of Critical Care Cardiology: Evidence, Models of Care, and Future Directions.Journal of the Society for Cardiovascular Angiography & Interventions · 2026
    Review
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  16. Hemodynamic Effects of Positive Airway Pressure: A Cardiologist's Overview.Journal of cardiovascular development and disease · 2025
    Review
  17. Article
  18. Review
  19. Article
  20. Article

1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Shashank S SinhaFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.). sssinha@med.umich.edu.
Michael W SjodingFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.).
Devraj SukulFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.).
Hallie C PrescottFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.).
Theodore J IwashynaFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.).
Hitinder S GurmFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.).
Colin R CookeFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.).
Brahmajee K NallamothuFrom the Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center (S.S.S., D.S., H.S.G., B.K.N.), Division of Pulmonary and Critical Care Medicine (M.W.S., H.C.P., T.J.I., C.R.C.), Michigan Integrated Center for Health Analytics and Medical Prediction, Institute for Healthcare Policy and Innovation (S.S.S., M.W.S., H.C.P., T.J.I., B.K.N.), and Michigan Center for Integrative Research in Critical Care (S.S.S., M.W.S., H.C.P., T.J.I., C.R.C., B.K.N.), University of Michigan, Ann Arbor; and Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, MI (H.C.P., T.J.I., H.S.G., B.K.N.).

Funding

PULMONARY CELLULAR AND MOLECULAR BIOLOGY TRAININGT32HL007749 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Robert Pickett Dickson · 1993 to 2026
$19.9M
TRAINING IN MOLECULAR AND CELLULAR CARDIOLOGYT32HL007853 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI David J. Pinsky · 1996 to 2026
$11.6M
Hospital Enhancement of Resuscitation Outcomes for In-Hospital Cardiac Arrest (HER01HL123980 · NHLBI · SAINT LUKE'S HOSPITAL · PI CHAN, PAUL SHEUNG-YAN, NALLAMOTHU, BRAHMAJEE K · 2014 to 2018
$2.7M
Intermittent Cold Exposure on the Endothelin SystemR01HL077490 · NHLBI · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI SUN, ZHONGJIE · 2006 to 2010
$1.8M
General pathways and personalized risk of morbidity after sepsisK08GM115859 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI PRESCOTT, HALLIE CHRISTINE · 2015 to 2018
$776k
Understanding Variation in the Use of Critical Care ServicesK08HS020672 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI COOKE, COLIN · 2012 to 2016
$768k
AHRQ HHS K08 HS020672NHLBI NIH HHS L30 HL134124NHLBI NIH HHS R01 HL077490NHLBI NIH HHS R01 HL123980NHLBI NIH HHS T32 HL007749NHLBI NIH HHS T32 HL007853NIGMS NIH HHS K08 GM115859
6 · The paper itself

Abstract

backgroundEarly reports suggest the number of cardiac intensive care unit (CICU) patients with primary noncardiac diagnoses is rising in the United States, but no national data currently exist. We examined changes in primary noncardiac diagnoses among elderly patients admitted to a CICU during the past decade. METHODS AND

resultsUsing 2003 to 2013 Medicare data, we grouped elderly patients admitted to CICUs into 2 categories based on principal diagnosis at discharge: (1) primary noncardiac diagnoses and (2) primary cardiac diagnoses. We examined changes in patient demographics, comorbidities, procedure use, and risk-adjusted in-hospital mortality. Among 3.4 million admissions with a CICU stay, primary noncardiac diagnoses rose in prevalence from 38.0% to 51.7% between 2003 and 2013. The fastest rising primary noncardiac diagnoses were infectious diseases (7.8%-15.1%) and respiratory diseases (6.0%-7.6%;

conclusionsMore than half of all elderly patients with a CICU stay across the United States now have primary noncardiac diagnoses at discharge. These patients receive different types of care and have worse outcomes than patients with primary cardiac diagnoses. Our work has important implications for the development of appropriate training and staffing models for the future critical care workforce.

Indexed as

AgedAged, 80 and overAge FactorsCommunicable DiseasesComorbidityCritical CareDatabases, FactualFemaleHealth Services Needs and DemandHealth Services ResearchHeart DiseasesHospital MortalityHumansIntensive Care UnitsMaleMedicarecoronary artery diseasecritical carehealth services researchheart failureintensive care units

Identifiers

PMID28794121
PMCPMC5657300

What OpenQuestion holds

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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.