Evidence map›Paper›PMID 30734216›Full record

ArticleGeneral thoracic and cardiovascular surgery2019

Predicted Risk of Mortality Score predicts 30-day readmission after coronary artery bypass grafting.

Joshua M Rosenblum, Brendan P Lovasik, John C Hunting, Jose Binongo, Michael E Halkos, Bradley G Leshnower, Jeffrey S Miller, Omar M Lattouf, Robert A Guyton, William B Keeling

Abstract read
PubMed Publisher
In one paragraph

Article in General thoracic and cardiovascular surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

  1. Pooled it
  2. Pooled it
  3. 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

10 authors.

Joshua M RosenblumDivision of Cardiac Surgery, Department of Surgery, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd, Suite A2202, Atlanta, GA, 30322, USA. jrosenblum@emory.edu.
Brendan P LovasikDepartment of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
John C HuntingDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Jose BinongoDepartment of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Michael E HalkosDivision of Cardiac Surgery, Department of Surgery, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd, Suite A2202, Atlanta, GA, 30322, USA.
Bradley G LeshnowerDivision of Cardiac Surgery, Department of Surgery, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd, Suite A2202, Atlanta, GA, 30322, USA.
Jeffrey S MillerDivision of Cardiac Surgery, Department of Surgery, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd, Suite A2202, Atlanta, GA, 30322, USA.
Omar M LattoufDivision of Cardiac Surgery, Department of Surgery, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd, Suite A2202, Atlanta, GA, 30322, USA.
Robert A GuytonDivision of Cardiac Surgery, Department of Surgery, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd, Suite A2202, Atlanta, GA, 30322, USA.
William B KeelingDivision of Cardiac Surgery, Department of Surgery, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd, Suite A2202, Atlanta, GA, 30322, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveQuality metrics and reimbursement models focus on 30-day readmission rates after coronary artery bypass grafting (CABG). Certain preoperative variables are associated with higher rates of readmission. The purpose of this study was to determine whether STS Predicted Risk of Mortality (PROM) scores predict 30-day readmission following CABG.

methodsA retrospective review of all patients undergoing isolated CABG between 2002 and 2017 at a US academic institution was performed. Logistic regression analysis was used to determine the association between PROM and 30-day readmission, and the area under the receiver-operator curve (ROC) was calculated to estimate predictive accuracy.

resultsDuring the study period, 21,719 patients underwent CABG and 2,023 (9.2%) were readmitted within 30 days. Readmitted patients were sicker with higher rates of comorbid conditions and higher STS PROM scores (1.03% vs 1.42%, GMR 1.33, CI 1.27-1.38, p < 0.0001). Median time to readmission was 8 days (IQR 4-15) with length of stay 5 days (4-6). By PROM quintile, higher PROM scores were associated with increased odds of readmission. PROM-adjusted 30-day mortality was higher in the readmitted group (1.04% vs 0.21%, OR 4.53, CI 2.67-7.69, p < 0.001), and mid-term survival was worse as well. PROM alone was a modest predictor of readmission (area under ROC 0.59, CI 0.57-0.60) compared to insurance status (0.55, 0.53-0.56), ejection fraction (0.52, 0.50-0.54), and history of heart failure (0.51, 0.50-0.52).

conclusionSTS PROM scores are associated with increased risk of readmission following CABG.

Indexed as

AgedCoronary Artery BypassFemaleHospital MortalityHumansLength of StayLogistic ModelsMaleMiddle AgedPatient ReadmissionQuality Indicators, Health CareRetrospective StudiesRisk AssessmentRisk FactorsROC CurveTime FactorsCABGReadmissionSTS PROM

Identifiers

PMID30734216

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.