Evidence map›Paper›PMID 32307181›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2021

Risk for non-home discharge following surgery for ischemic mitral valve disease.

Anuradha Lala, Helena L Chang, Xiaoyu Liu, Eric J Charles, Babatunde A Yerokun, Michael E Bowdish, Vinod H Thourani, Michael J Mack, Marissa A Miller, Patrick T O'Gara and 6 more

Abstract readMulticenter Study
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Anuradha LalaPopulation Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: anu.lala@mountsinai.org.
Helena L ChangPopulation Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Xiaoyu LiuPopulation Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Eric J CharlesSection of Adult Cardiac Surgery, University of Virginia, Charlottesville, Va.
Babatunde A YerokunSurgery, Duke University Medical Center, Durham, NC.
Michael E BowdishSurgery, Keck School of Medicine, University of Southern California, Los Angeles, Calif.
Vinod H ThouraniCardiac Surgery, MedStar Heart and Vascular Institute, Washington, DC.
Michael J MackCardiothoracic Surgery, Baylor Research Institute, Baylor Scott & White Health, Plano, Tex.
Marissa A MillerDivision of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Md.
Patrick T O'GaraCardiovascular Division, Brigham and Women's Hospital, Boston, Mass.
Eugene H BlackstoneThoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
Alan J MoskowitzPopulation Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Annetine C GelijnsPopulation Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
John C MullenDivision of Cardiac Surgery, University of Alberta, Edmonton, Alberta, Canada.
Lynne W StevensonCardiovascular Medicine, Medicine, Vanderbilt University Medical Center, Nashville, Tenn.
Cardiothoracic Surgical Trials Network (CTSN) Working Group

Funding

REVISED CAROL ACT IIU01HL088942 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GELIJNS, ANNE CHRISTINE, MOSKOWITZ, ALAN J · 2007 to 2025
$122.6M
USC Cardiothoracic Surgical Trials Network Core Clinical CenterUM1HL117924 · NHLBI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI ALLEN, KEITH B., STARNES, VAUGHN A · 2013 to 2025
$7.0M
Cleveland Clinic Cardiothoracic Collaborative Clinical Center (C6)UM1HL088955 · NHLBI · CLEVELAND CLINIC LERNER COM-CWRU · PI GILLINOV, ALAN MARC, PARRINO, PATRICK E · 2013 to 2025
$6.6M
NHLBI NIH HHS U01 HL088942NHLBI NIH HHS UM1 HL088955NHLBI NIH HHS UM1 HL117924
6 · The paper itself

Abstract

objectivesTo determine the frequency and risk factors for non-home discharge (NHD) and its association with clinical outcomes and quality of life (QOL) at 1 year following cardiac surgery in patients with ischemic mitral regurgitation (IMR).

methodsDischarge disposition was evaluated in 552 patients enrolled in trials of severe or moderate IMR. Patient and in-hospital factors associated with NHD were identified using logistic regression. Subsequently, association of NHD with 1-year mortality, serious adverse events (SAEs), and QOL was assessed.

resultsNHD was observed in 30% (154/522) with 25% (n = 71/289) in moderate and 36% (n = 83/233) in patients with severe IMR (unadjusted P = .006), a difference not significant after including age (5-year change: adjusted odds ratio [adjOR], 1.52; 95% confidence interval [CI], 1.35-1.72; P < .001), diabetes (adjOR, 1.94; 95% CI, 1.27-2.94; P = .002), and previous heart failure (adjOR, 1.64; 95% CI, 1.06-2.52; P = .03). Odds of NHD were increased for patients with postoperative SAEs (adjOR, 1.85; 95% CI, 1.19-2.86; P = .01) but not based on type of cardiac surgery. Greater rates of death and SAEs were observed in NHD patients at 1 year: adjusted hazard ratio, 4.29 (95% CI, 2.14-8.59; P < .001) and adjusted rate ratio, 1.45 (95% CI, 1.03-2.02; P = .03), respectively. QOL did not differ significantly between groups.

conclusionsNHD is common following surgery for IMR, influenced by older age, diabetes, previous heart failure, and postoperative SAEs. These patients may be at greater risk of death and subsequent SAEs after discharge. Discussion of NHD with patients may have important implications for decision-making and guiding expectations following cardiac surgery.

Indexed as

Patient DischargeQuality of LifeAgedFemaleHumansMaleMiddle AgedMitral Valve InsufficiencyMyocardial IschemiaProspective StudiesRisk AssessmentRisk FactorsTreatment Outcomemitral regurgitationmitral valve diseasenon-home dischargepostoperative SAEquality of life

Identifiers

PMID32307181
PMCPMC7874266

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.