Evidence map›Paper›PMID 34212757›Full record

Observational studyJournal of the American Heart Association2021

Area Deprivation Index and Cardiac Readmissions: Evaluating Risk-Prediction in an Electronic Health Record.

Amber E Johnson, Jianhui Zhu, William Garrard, Floyd W Thoma, Suresh Mulukutla, Kiarri N Kershaw, Jared W Magnani

Open access · goldAbstract readComparative StudyObservational Study
In one paragraph

Observational study in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 1 pooled it
18.0field-weighted citation impact, top 1% 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

74 citing papers in PubMed, 1 synthesis or guideline pooled it, 110 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
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  5. The Association of Neighborhood Disadvantage with Surgical Outcomes and Follow-Up Adherence in Patients with Cleft Lip.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026
    Article
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  7. Review
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  9. Role of social determinants and outcomes of patients with alcohol-associated liver disease referred for early liver transplantation: A multicenter analysis.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026
    Article
  10. Clinical and Socioeconomic Predictors of 60-Day Rehospitalization After Oncologic Head and Neck Surgery.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
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14 more citing papers are in PubMed but not listed here.

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 3 institutions in 1 country.

Amber E JohnsonDivision of Cardiology Department of Medicine UPMC Heart and Vascular Institute University of Pittsburgh PA.
Jianhui ZhuDivision of Cardiology Department of Medicine UPMC Heart and Vascular Institute University of Pittsburgh PA.
William GarrardClinical Analytics Department UPMC Pittsburgh PA.
Floyd W ThomaDivision of Cardiology Department of Medicine UPMC Heart and Vascular Institute University of Pittsburgh PA.
Suresh MulukutlaDivision of Cardiology Department of Medicine UPMC Heart and Vascular Institute University of Pittsburgh PA.
Kiarri N KershawDepartment of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL.
Jared W MagnaniDivision of Cardiology Department of Medicine UPMC Heart and Vascular Institute University of Pittsburgh PA.
University of Pittsburgh · USNorthwestern University · USUPMC Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Assessment of the social determinants of post-hospital cardiac care is needed. We examined the association and predictive ability of neighborhood-level determinants (area deprivation index, ADI), readmission risk, and mortality for heart failure, myocardial ischemia, and atrial fibrillation. Methods and Results Using a retrospective (January 1, 2011-December 31, 2018) analysis of a large healthcare system, we assess the predictive ability of ADI on 30-day and 1-year readmission and mortality following hospitalization. Cox proportional hazards models analyzed time-to-event. Log rank analyses determined survival. C-statistic and net reclassification index determined the model's discriminative power. Covariates included age, sex, race, comorbidity, number of medications, length of stay, and insurance. The cohort (n=27 694) had a median follow-up of 46.5 months. There were 14 469 (52.2%) men and 25 219 White (91.1%) patients. Patients in the highest ADI quintile (versus lowest) were more likely to be admitted within 1 year of index heart failure admission (hazard ratio [HR], 1.25; 95% CI, 1.03‒1.51). Patients with myocardial ischemia in the highest ADI quintile were twice as likely to be readmitted at 1 year (HR, 2.04; 95% CI, 1.44‒2.91]). Patients with atrial fibrillation living in areas with highest ADI were less likely to be admitted within 1 year (HR, 0.79; 95% CI, 0.65‒0.95). As ADI increased, risk of readmission increased, and risk reclassification was improved with ADI in the models. Patients in the highest ADI quintile were 25% more likely to die within a year (HR, 1.25 1.08‒1.44). Conclusions Residence in socioeconomically disadvantaged communities predicts rehospitalization and mortality. Measuring neighborhood deprivation can identify individuals at risk following cardiac hospitalization.

Indexed as

Electronic Health RecordsPatient ReadmissionResidence CharacteristicsSocial Determinants of HealthSocioeconomic FactorsAgedAged, 80 and overAtrial FibrillationFemaleHeart FailureHumansMaleMiddle AgedMyocardial IschemiaPennsylvaniaPrognosiselectronic health recordreadmissionsrisk predictionsocial determinants of health

Identifiers

PMID34212757
PMCPMC8403312
OpenAlexW3176352270

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.