Evidence map›Paper›PMID 28973634›Full record

ArticleAnnals of internal medicine2017

Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling.

Kumar Dharmarajan, Robert L McNamara, Yongfei Wang, Frederick A Masoudi, Joseph S Ross, Erica E Spatz, Nihar R Desai, James A de Lemos, Gregg C Fonarow, Paul A Heidenreich and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

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

  1. Pooled it
  2. Review
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Kumar DharmarajanFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Robert L McNamaraFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Yongfei WangFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Frederick A MasoudiFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Joseph S RossFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Erica E SpatzFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Nihar R DesaiFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
James A de LemosFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Gregg C FonarowFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Paul A HeidenreichFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Deepak L BhattFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Susannah M BernheimFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Lara E SlatteryFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Yosef M KhanFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.
Jeptha P CurtisFrom Clover Health, Jersey City, New Jersey; Center for Outcomes Research & Evaluation, Yale New Haven Health, and Yale School of Medicine, New Haven, Connecticut; University of Colorado Anschutz Medical Campus, Denver, Colorado; University of Texas Southwestern Medical Center and American Heart Association, Dallas, Texas; Ronald Reagan UCLA Medical Center, Los Angeles, California; Stanford University Medical Center, Palo Alto, California; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; and American College of Cardiology, Washington, DC.

Funding

Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Denise Esserman · 2002 to 2026
$37.9M
Center for Cardiovascular Outcomes Research at Yale UniversityU01HL105270 · NHLBI · YALE UNIVERSITY · PI CURTIS, JEPTHA PELHAM, KRUMHOLZ, HARLAN MARC · 2010 to 2013
$5.8M
Geriatric Conditions and Readmission after Acute Myocardial InfarctionK23AG048331 · NIA · YALE UNIVERSITY · PI DHARMARAJAN, KUMAR · 2014 to 2017
$692k
AHRQ HHS K12 HS023000NHLBI NIH HHS U01 HL105270NIA NIH HHS K23 AG048331NIA NIH HHS P30 AG021342
6 · The paper itself

Abstract

backgroundPublicly reported hospital risk-standardized mortality rates (RSMRs) for acute myocardial infarction (AMI) are calculated for Medicare beneficiaries. Outcomes for older patients with AMI may not reflect general outcomes.

objectiveTo examine the relationship between hospital 30-day RSMRs for older patients (aged ≥65 years) and those for younger patients (aged 18 to 64 years) and all patients (aged ≥18 years) with AMI.

designRetrospective cohort study.

setting986 hospitals in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines.

participantsAdults hospitalized for AMI from 1 October 2010 to 30 September 2014. MEASUREMENTS: Hospital 30-day RSMRs were calculated for older, younger, and all patients using an electronic health record measure of AMI mortality endorsed by the National Quality Forum. Hospitals were ranked by their 30-day RSMRs for these 3 age groups, and agreement in rankings was plotted. The correlation in hospital AMI achievement scores for each age group was also calculated using the Hospital Value-Based Purchasing (HVBP) Program method computed with the electronic health record measure.

results267 763 and 276 031 AMI hospitalizations among older and younger patients, respectively, were identified. Median hospital 30-day RSMRs were 9.4%, 3.0%, and 6.2% for older, younger, and all patients, respectively. Most top- and bottom-performing hospitals for older patients were neither top nor bottom performers for younger patients. In contrast, most top and bottom performers for older patients were also top and bottom performers for all patients. Similarly, HVBP achievement scores for older patients correlated weakly with those for younger patients (R = 0.30) and strongly with those for all patients (R = 0.92). LIMITATION: Minority of U.S. hospitals.

conclusionHospital mortality rankings for older patients with AMI inconsistently reflect rankings for younger patients. Incorporation of younger patients into assessment of hospital outcomes would permit further examination of the presence and effect of age-related quality differences. PRIMARY FUNDING SOURCE: American College of Cardiology.

Indexed as

Hospital MortalityOutcome Assessment, Health CareAdolescentAdultAgedAge FactorsHospitalsHumansMiddle AgedMyocardial InfarctionRetrospective StudiesUnited StatesYoung Adult

Identifiers

PMID28973634
PMCPMC9359429

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.