Evidence map›Paper›PMID 35593458›Full record

ArticleJournal of the American Geriatrics Society2022

Prevalence of co-occurring serious illness diagnoses and association with health care utilization at the end of life.

Stephanie Nothelle, Alanna M Chamberlain, Debra Jacobson, Ariel R Green, Cynthia M Boyd, Walter A Rocca, Chun Fan, Jennifer L St Sauver

Open access · hybridAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 25% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

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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

8 authors at 3 institutions in 1 country.

Stephanie NothelleCenter for Transformative Geriatrics Research, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0003-3908-286X
Alanna M ChamberlainDivision of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Debra JacobsonDivision of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Ariel R GreenCenter for Transformative Geriatrics Research, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0003-4127-4617
Cynthia M BoydCenter for Transformative Geriatrics Research, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Walter A RoccaDivision of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Chun FanDivision of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Jennifer L St SauverDivision of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Johns Hopkins University · USMayo Clinic · USMayo Clinic in Arizona · US

Funding

Multiple Chronic Conditions and AgingR01AG052425 · NIA · MAYO CLINIC ROCHESTER · PI ROCCA, WALTER A, ST SAUVER, JENNIFER LYNN · 2017 to 2021
$3.3M
Interdisciplinary Infrastructure for Aging Research: Rochester Epidemiology ProjectR33AG058738 · NIA · MAYO CLINIC ROCHESTER · PI LEBRASSEUR, NATHAN K, OLSON, JANET E · 2020 to 2022
$2.4M
Patient-Centered Care for Older Adults with Multiple Chronic Conditions: Research and Mentoring ProgramK24AG056578 · NIA · JOHNS HOPKINS UNIVERSITY · PI BOYD, CYNTHIA MELINDA · 2017 to 2021
$1.1M
Primary care based collaborative approach to care management for older adults with dementiaK23AG072037 · NIA · JOHNS HOPKINS UNIVERSITY · PI NOTHELLE, STEPHANIE · 2021 to 2025
$946k
Bladder Antimuscarinics in Dementia: A Model of Decisions About Potentially Inappropriate MedicinesK23AG054742 · NIA · JOHNS HOPKINS UNIVERSITY · PI GREEN, ARIEL · 2017 to 2020
$795k
Interdisciplinary Infrastructure for Aging Research: Rochester Epidemiology ProjectR21AG058738 · NIA · MAYO CLINIC ROCHESTER · PI LEBRASSEUR, NATHAN K, OLSON, JANET E · 2018 to 2019
$437k
Characterization and effect of co-existence of care management programs for high need, high cost older adultsR03AG060170 · NIA · JOHNS HOPKINS UNIVERSITY · PI NOTHELLE, STEPHANIE · 2018 to 2019
$246k
NIA NIH HHS K23 AG054742NIA NIH HHS K23 AG072037NIA NIH HHS K24 AG056578NIA NIH HHS L30 AG064736NIA NIH HHS R01 AG052425NIA NIH HHS R03 AG060170NIA NIH HHS R21 AG058738NIA NIH HHS R33 AG058738
6 · The paper itself

Abstract

introductionEnd-of-life care differs by serious illness diagnosis. Cancer and dementia are serious illnesses that have been associated with less intensive end-of-life health care use. It is not known how health care utilization varies in the presence of >1 serious illness.

methodsWe used the Rochester Epidemiology Project to identify persons living in a midwestern area who died on July 1, 2017-June 30, 2018 at age ≥65 years, and were seriously ill. We examined the number of emergency department (ED), hospital, and intensive care unit (ICU) stays in the last 6 months and the last 30 days of life. We used Poisson regression to determine the incidence rate ratio for ED, hospital, and ICU stay in the last 6 months and 30 days of life by number of serious illness diagnoses. For cancer and dementia, we examined the effect of an additional serious illness.

resultsWe included a population of 1372 adults who were, on average, 84 years, 52% female, and 96% white. Approximately 41% had multiple serious illnesses. Compared to older adults with 1 serious illness diagnosis, rates of hospitalization, and ICU stay for adults with 2 or ≥3 serious illness diagnoses were at least 1.5 times higher in the last 6 months and the last 30 days of life. Rates of ED visits were significantly higher for older adults with 2 or ≥3 serious illness diagnoses in the last 6 months of life, but only higher for those with ≥3 versus 1 serious illness diagnosis in the last 30 days of life. For both cancer and dementia, rates of ED visits, hospitalization and ICU stay were lower for the condition alone than when an additional serious illness diagnosis was present.

conclusionHaving multiple serious illnesses increases the risk of health care utilization at the end of life.

Indexed as

DementiaNeoplasmsTerminal CareAgedDeathDelivery of Health CareEmergency Service, HospitalFemaleHospitalizationHumansMalePatient Acceptance of Health CarePrevalenceRetrospective Studiesend-of-lifehealth care utilizationserious illness

Identifiers

PMID35593458
PMCPMC9489605
OpenAlexW4280578474

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.