Evidence map›Paper›PMID 30482758›Full record

ArticleCMAJ open

Readmission following hypoxic ischemic brain injury: a population-based cohort study.

Vincy Chan, David Stock, Binu Jacob, Nora Cullen, Angela Colantonio

Abstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. 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

5 authors.

Vincy ChanToronto Rehabilitation Institute (Chan, Stock, Jacob, Cullen, Colantonio), University Health Network, Toronto, Ont.; Department of Clinical Health and Epidemiology (Stock), Dalhousie University, Halifax, NS; West Park Healthcare Centre (Cullen); Rehabilitation Sciences Institute (Cullen, Colantonio), University of Toronto; Institute for Clinical Evaluative Sciences (Colantonio), Toronto, Ont. Vincy.Chan@uhn.ca.
David StockToronto Rehabilitation Institute (Chan, Stock, Jacob, Cullen, Colantonio), University Health Network, Toronto, Ont.; Department of Clinical Health and Epidemiology (Stock), Dalhousie University, Halifax, NS; West Park Healthcare Centre (Cullen); Rehabilitation Sciences Institute (Cullen, Colantonio), University of Toronto; Institute for Clinical Evaluative Sciences (Colantonio), Toronto, Ont.
Binu JacobToronto Rehabilitation Institute (Chan, Stock, Jacob, Cullen, Colantonio), University Health Network, Toronto, Ont.; Department of Clinical Health and Epidemiology (Stock), Dalhousie University, Halifax, NS; West Park Healthcare Centre (Cullen); Rehabilitation Sciences Institute (Cullen, Colantonio), University of Toronto; Institute for Clinical Evaluative Sciences (Colantonio), Toronto, Ont.
Nora CullenToronto Rehabilitation Institute (Chan, Stock, Jacob, Cullen, Colantonio), University Health Network, Toronto, Ont.; Department of Clinical Health and Epidemiology (Stock), Dalhousie University, Halifax, NS; West Park Healthcare Centre (Cullen); Rehabilitation Sciences Institute (Cullen, Colantonio), University of Toronto; Institute for Clinical Evaluative Sciences (Colantonio), Toronto, Ont.
Angela ColantonioToronto Rehabilitation Institute (Chan, Stock, Jacob, Cullen, Colantonio), University Health Network, Toronto, Ont.; Department of Clinical Health and Epidemiology (Stock), Dalhousie University, Halifax, NS; West Park Healthcare Centre (Cullen); Rehabilitation Sciences Institute (Cullen, Colantonio), University of Toronto; Institute for Clinical Evaluative Sciences (Colantonio), Toronto, Ont.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReadmission to acute care is common and is associated with indicators of suboptimal care and health system inefficiencies. The objective of this study was to identify independent determinants of readmission following survival of hypoxic ischemic brain injury.

methodsWe conducted a population-based retrospective cohort study using Ontario's administrative health data. Survivors of hypoxic ischemic brain injury aged 20 years or more discharged from acute care between fiscal years 2002/03 and 2010/11 were included. Multivariable negative binomial regression was used to identify independent determinants of both number of readmissions and cumulative duration of hospital stay(s) within 1 year after the index discharge.

resultsOf the 593 patients with hypoxic ischemic brain injury, 233 (39.3%) were readmitted within 1 year of the index acute care discharge. The number of readmissions was associated with age (35-49 yr v. 65-79 yr: rate ratio [RR] 0.57, 95% confidence interval [CI] 0.38-0.85; ≥ 80 yr v. 65-79 yr: RR 0.58, 95% CI 0.34-0.97) and higher comorbidity score (Johns Hopkins Aggregated Diagnosis Groups score > 30 v. < 10: RR 1.60, 95% CI 1.11-2.31). Cumulative readmission stay was associated with increased index acute care length of stay (31-90 d v. ≥ 90 d: RR 4.17, 95% CI 1.38-12.64), prior use of health care services (minimal v. very high: RR 0.15, 95% CI 0.05-0.49) and discharge disposition (home v. continuing/long-term care: RR 0.44, 95% CI 0.21-0.91).

interpretationThe findings indicate a high readmission rate in the first year after the index acute care admission for survivors of hypoxic ischemic brain injury, reflecting care gaps and system inefficiencies. This suggests that bolstered discharge and home care planning and support are needed to address the specific needs of those with hypoxic ischemic brain injury.

Identifiers

PMID30482758
PMCPMC6263420

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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.