Evidence map›Paper›PMID 32710813›Full record

ArticleJournal of the American Geriatrics Society2020

The Black and White of Invasive Mechanical Ventilation in Advanced Dementia.

Rashmi K Sharma, Hyosin Kim, Pedro L Gozalo, Donald R Sullivan, Jennifer Bunker, Joan M Teno

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.0field-weighted citation impact, top 13% 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

9 citing papers in PubMed, 15 citations in OpenAlex.

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  5. Mapping racial and ethnic healthcare disparities for persons living with dementia: A scoping review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
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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

6 authors at 3 institutions in 1 country.

Rashmi K SharmaDivision of General Internal Medicine, University of Washington, Seattle, Washington, USA.
Hyosin KimDivision of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, Oregon, USA.ORCID 0000-0002-9890-7166
Pedro L GozaloDepartment of Health Services, Policy, and Practice, Center for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, Rhode Island, USA.
Donald R SullivanDivision of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, USA.
Jennifer BunkerDivision of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, Oregon, USA.
Joan M TenoDivision of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, Oregon, USA.
Oregon Health & Science University · USRhode Island Department of Health · USUniversity of Washington · US

Funding

VARIATIONS IN LIFE'S FINAL CHAPTERP01AG027296 · NIA · BROWN UNIVERSITY · PI AMAL N. TRIVEDI · 2007 to 2026
$38.9M
Invasive and Non-Invasive Mechanical Ventilation Outcomes in Advanced DementiaR56AG063748 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI TENO, JOAN M · 2019 to 2020
$710k
NIA NIH HHS P01 AG027296NIA NIH HHS R56 AG063748NIA NIH HHS R56 AG063748-02
6 · The paper itself

Abstract

BACKGROUND/

objectivesOver the past decade, feeding tube use in nursing home residents with advanced dementia has declined by 50% among white and black patients. Little is known about whether a similar reduction has occurred in other invasive interventions, such as mechanical ventilation.

designRetrospective cohort study.

settingAcute-care hospitals in the United States.

participantsMedicare beneficiaries with advanced dementia who previously resided in a nursing home and were hospitalized between 2001 and 2014 with pneumonia and/or septicemia and of either black or white race. MEASUREMENT: Invasive mechanical ventilation (IMV), as identified by International Classification of Diseases (ICD) procedure codes. Two multivariable logistic regression models examined the association between race and the likelihood of receiving IMV, adjusting for patients' demographics, physical function, and comorbidities. A hospital fixed-effects model examined the association of race within a hospital, whereas a random-effects logistic model was used to estimate the between-hospital variation in the probability of receiving IMV and examine the overall association of race and use of IMV.

resultsBetween 2001 and 2014, 289,017 patients with advanced dementia were hospitalized for pneumonia or septicemia. Use of IMV increased from 3.7% to 12.1% in white patients and from 8.6% to 21.8% in blacks. Among those ventilated, 1-year mortality rates remained high, at 82.7% for whites and 84.2% for blacks dying in 2013. Compared with whites, blacks had a higher odds of receiving IMV in the fixed-effects (within-hospital) model (adjusted odds ratio (AOR) = 1.34; 95% confidence interval (CI) = 1.29-1.39) and in the random-effects (between-hospital) model (AOR = 1.46; 95% CI = 1.40-1.51).

conclusionIMV use in patients with advanced dementia has increased substantially, with black patients having a larger increase than whites, based, in part, on the hospitals where black patients receive care.

Indexed as

Intensive Care UnitsRespiration, ArtificialAged, 80 and overBlack or African AmericanComorbidityDementiaFemaleHospital MortalityHospitalsHumansMaleMedicarePneumoniaRetrospective StudiesSepsisUnited Statesinvasive mechanical ventilationracesecular trends

Identifiers

PMID32710813
PMCPMC7722138
OpenAlexW3044465307

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.