Evidence map›Paper›PMID 31284063›Full record

ArticleWorld neurosurgery2019

Nonindex Readmission After Ruptured Brain Aneurysm Treatment Is Associated with Higher Morbidity and Repeat Readmission.

Austin M Tang, Joshua Bakhsheshian, Li Ding, Casey A Jarvis, Edith Yuan, Ben Strickland, Steven L Giannotta, Arun Amar, Frank J Attenello, William J Mack

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World neurosurgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
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

4 citing papers in PubMed, 8 citations in OpenAlex.

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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 at 1 institution in 1 country.

Austin M TangKeck School of Medicine, University of Southern California, Los Angeles, California, USA. Electronic address: austint@usc.edu.
Joshua BakhsheshianDepartment of Neurological, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Li DingDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Casey A JarvisKeck School of Medicine, University of Southern California, Los Angeles, California, USA.
Edith YuanKeck School of Medicine, University of Southern California, Los Angeles, California, USA.
Ben StricklandDepartment of Neurological, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Steven L GiannottaDepartment of Neurological, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Arun AmarDepartment of Neurological, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Frank J AttenelloDepartment of Neurological, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
William J MackDepartment of Neurological, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
University of Southern California · US

Funding

Mentored Career DevelopmentKL2TR001854 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Elizabeth Rhea Erwin Burner, Amy Elizabeth West · 2016 to 2026
$9.0M
NCATS NIH HHS KL2 TR001854
6 · The paper itself

Abstract

backgroundAneurysmal subarachnoid hemorrhage (aSAH) requires complex multidisciplinary care. After initial treatment (index hospital), readmission to a different hospital (nonindex) can compromise quality of care, resulting in increased morbidity. We aimed to evaluate factors associated with nonindex readmission and evaluate association of nonindex hospital readmission on outcomes in patients with ruptured aneurysm.

methodsReadmissions within 90 days after aSAH treatment were identified in the 2010-2014 Nationwide Readmissions Database. Multivariable logistic regression identified patient and hospital characteristics associated with nonindex readmission. Separate multivariable models determined increased morbidity or risk of second readmission for nonindex readmissions.

resultsA total of 9254 patients who underwent treatment of ruptured aneurysms from 2010 to 2014 were identified. Of these, 1985 (21.5%) were readmitted within 90 days. Three hundred and fifty-five of these readmissions (17.9%) occurred to nonindex hospitals. Patients that were discharged to a skilled nursing or other facility (odds ratio [OR], 1.70; 95% confidence interval [CI], 1.27-2.28]) had higher odds of nonindex readmission, whereas patients with private insurance were associated with lower odds of nonindex readmission (OR, 0.65; 95% CI, 0.46-0.92). Patients readmitted to a nonindex (vs. index) hospital were associated with increased likelihood of major complications (OR, 1.71; 95% CI, 1.18-2.48) and second readmissions (OR, 1.51; 95% CI, 1.17-1.96).

conclusionsAfter treatment of a ruptured cerebral aneurysm, 17.9% of readmissions occurred at a nonindex hospital. These patients were at increased risk for major complications or subsequent readmissions, which may be because of care fragmentation. Interventions aimed at improving continuity of care may reduce higher morbidity associated with nonindex readmission.

Indexed as

AdolescentAdultAgedAged, 80 and overAneurysm, RupturedFemaleHumansIntracranial AneurysmMaleMiddle AgedMorbidityPatient ReadmissionRetrospective StudiesRisk FactorsTreatment OutcomeYoung AdultCare fragmentationCerebral aneurysmContinuity of careNonindex readmissionQuality improvementSubarachnoid hemorrhage

Identifiers

PMID31284063
PMCPMC6778018
OpenAlexW2954304701

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.