Evidence map›Paper›PMID 32673434›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2020

Risk Factors for Disability After Emergency Department Discharge in Older Adults.

Justine M Nagurney, Ling Han, Linda Leo-Summers, Heather G Allore, Thomas M Gill

Open access · bronzeAbstract read
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 24% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Effectiveness of a care transitions intervention for older adults discharged home from the emergency department: A randomized controlled trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022
    Trial
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 at 2 institutions in 1 country.

Justine M NagurneyFrom the, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.ORCID 0000-0002-2795-4555
Ling Hanand the, Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA.
Linda Leo-Summersand the, Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA.
Heather G Alloreand the, Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA.
Thomas M Gilland the, Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0002-6450-0368
Yale University · USBeth Israel Deaconess Medical Center · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Albert C Shaw · 2002 to 2026
$37.9M
VULNERABILITY, INTERVENING EVENTS &DISABILITY IN AGINGR01AG017560 · NIA · YALE UNIVERSITY · PI GILL, THOMAS MICHAEL · 2000 to 2025
$7.0M
ACADEMIC LEADERSHIP AWARD IN DISABILITY AND DISABLING DISORDERSK07AG043587 · NIA · YALE UNIVERSITY · PI GILL, THOMAS MICHAEL · 2013 to 2017
$645k
NCATS NIH HHS UL1 TR001863NIA NIH HHS K07 AG043587NIA NIH HHS P30 AG021342NIA NIH HHS R01 AG017560
6 · The paper itself

Abstract

objectivesWe have previously shown that older adults discharged from the emergency department (ED) experience an increased disability burden within a 6-month time period after ED discharge. The objective of this study was to identify risk factors associated with increased disability burden among older adults discharged from the ED.

methodsThis study is part of an ongoing longitudinal study of 754 community-living persons aged ≥70 years. The analytic sample included 813 ED visits without hospitalization from 430 participants who had at least one visit to an ED during a 14-year follow-up period (1998-2012). Information on ED visits and disability burden in 13 functional activities was collected during monthly interviews. Twenty-nine candidate risk factors were evaluated for their independent associations with increased disability burden using a longitudinal multivariable model.

resultsIn the multivariable analyses, age ≥85 (adjusted risk ratio [aRR] = 1.14, 95% confidence interval [CI] = 1.05 to 1.24), being unmarried (aRR = 1.15, 95% CI = 1.05 to 1.27), lower-extremity weakness (aRR = 1.20, 95% CI = 1.07 to 1.34), and physical frailty (aRR = 1.25, 95% CI = 1.13 to 1.37) were associated with increased disability burden. As the number of risk factors increased, the predicted mean disability burden (on a scale of 0 to 13) also increased, ranging from a value of 1.80 (95% CI = 1.43 to 2.27) for 0 risk factors to a value of 8.59 (95% CI = 7.93 to 9.29) for four risk factors.

conclusionsAmong older adults discharged from the ED, several risk factors were associated with increased disability burden over the following 6 months, including age ≥85, being unmarried, lower-extremity weakness, and physical frailty. Further research is needed to evaluate whether risk stratification based on nonmodifiable factors or interventions targeting modifiable risk factors improve functional outcomes for older adults discharged from the ED.

Indexed as

Emergency Service, HospitalPatient DischargePersons with DisabilitiesAgedAged, 80 and overFemaleHumansLongitudinal StudiesMaleOdds RatioRisk Factors

Identifiers

PMID32673434
PMCPMC7749835
OpenAlexW3043215903

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.