Evidence map›Paper›PMID 32828874›Full record

ArticleAmerican journal of ophthalmology2021

Cataract Surgery Complexity and Surgical Complication Rates Among Medicare Beneficiaries With and Without Dementia.

Suzann Pershing, Victor W Henderson, Mary K Goldstein, Ying Lu, M Kate Bundorf, Moshiur Rahman, Joshua D Stein

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

Article in American journal of ophthalmology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
  5. Review
  6. Article
  7. Hospital admissions and emergency department visits for people with dementia.QJM : monthly journal of the Association of Physicians · 2024
    Article
  8. 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

7 authors at 4 institutions in 2 countries.

Suzann PershingByers Eye Institute at Stanford, Palo Alto, California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA; Department of Health Research and Policy (Health Services Research), Stanford University, Palo Alto, California, USA. Electronic address: pershing@stanford.edu.
Victor W HendersonDepartment of Epidemiology and Population Health, Stanford University, Palo Alto, California, USA; Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, California, USA; Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
Mary K GoldsteinVA Palo Alto Health Care System, Palo Alto, California, USA; Department of Medicine, Stanford University, Stanford, California, USA.
Ying LuDepartment of Biomedical Data Science, Stanford University, Palo Alto, California, USA.
M Kate BundorfDepartment of Health Research and Policy (Health Services Research), Stanford University, Palo Alto, California, USA.
Moshiur RahmanByers Eye Institute at Stanford, Palo Alto, California, USA; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA; Center for Eye Policy and Innovation, and School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Joshua D SteinDepartment of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA; Center for Eye Policy and Innovation, and School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Stanford University · USSmith-Kettlewell Eye Research Institute · USUniversity of Michigan–Ann Arbor · USVA Palo Alto Health Care System · US

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
Stanford Vision Research CoreP30EY026877 · NEI · STANFORD UNIVERSITY · PI Jeffrey L Goldberg · 2017 to 2026
$8.0M
Working Memory in Parkinson Disease: A Cognitive & Systems Neuroscience ApproachP50AG047366 · NIA · STANFORD UNIVERSITY · PI HENDERSON, VICTOR · 2015 to 2019
$7.9M
Stanford Medicine Center for Longevity and Healthy Aging Research Education CoreP30AG059307 · NIA · STANFORD UNIVERSITY · PI ZOU, JAMES · 2018 to 2025
$4.9M
Personalized Forecasting of Disease Trajectory for Patients with Open Angle GlaucomaR01EY026641 · NEI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LAVIERI-WILLIAMS, MARIEL SOFIA, STEIN, JOSHUA D · 2016 to 2020
$2.9M
Impact and outcomes of cataract surgery among patients with Alzheimer's DiseaseR03AG056453 · NIA · STANFORD UNIVERSITY · PI PERSHING, SUZANN · 2017 to 2018
$236k
NCATS NIH HHS UL1 TR003142NEI NIH HHS P30 EY026877NEI NIH HHS R01 EY026641NIA NIH HHS P30 AG059307NIA NIH HHS P50 AG047366NIA NIH HHS R03 AG056453
6 · The paper itself

Abstract

purposeTo evaluate cataract surgery complexity and complications among US Medicare beneficiaries with and without dementia.

designRetrospective claims-based cohort study.

participantsA 20% representative sample of Medicare beneficiaries, 2006-2015.

methodsDementia was identified from diagnosis codes on or prior to each beneficiary's first-eye cataract surgery. For each surgery, we identified setting, routine vs complex coding, anesthesia provider type, duration, and any postoperative hospitalization. We evaluated 30- and 90-day complication rates-return to operating room, endophthalmitis, suprachoroidal hemorrhage, retinal detachment, retinal tear, macular edema, glaucoma, or choroidal detachment-and used adjusted regression models to evaluate likelihood of surgical characteristics and complications. Complication analyses were stratified by second-eye cataract surgery within 90 days postoperatively.

resultsWe identified 457,128 beneficiaries undergoing first-eye cataract surgery, 23,332 (5.1%) with dementia. None of the evaluated surgical complications were more likely in dementia-diagnosed beneficiaries. There was also no difference in likelihood of nonambulatory surgery center setting, anesthesiologist provider, or postoperative hospitalization. Dementia-diagnosed beneficiaries were more likely to have surgeries coded as complex (15.6% of cases vs 8.8%, P < .0001), and surgeries exceeding 30 minutes (OR = 1.21, 95% CI = 1.17-1.25).

conclusionsAmong US Medicare beneficiaries undergoing cataract surgery, those with dementia are more likely to have "complex" surgery" lasting more than 30 minutes. However, they do not have greater likelihood of surgical complications, higher-acuity setting, advanced anesthesia care, or postoperative hospitalization. This may be influenced by case selection and may suggest missed opportunities to improve vision. Future research is needed to identify dementia patients likely to benefit from cataract surgery.

Indexed as

AgedAged, 80 and overCataractCataract ExtractionChoroid HemorrhageDementiaEndophthalmitisFemaleGlaucomaHumansIntraoperative ComplicationsMacular EdemaMaleMedicarePostoperative ComplicationsRetinal Detachment

Identifiers

PMID32828874
PMCPMC7736486
OpenAlexW3081276543

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.