ArticleJournal of general internal medicine2023
The Impact of Discharge Against Medical Advice on Readmission After Opioid Use Disorder-Associated Infective Endocarditis: a National Cohort Study.
Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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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.
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.
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Who cites it
12 citing papers in PubMed, 14 citations in OpenAlex.
- Patient-Directed Discharge Among Hospitalized Persons With Opioid Use Disorder in the Fentanyl Era: A Scoping Review.American journal of medicine open · 2026Review
- Failure to Treat Opioid Use Disorder and Opioid Withdrawal Associated with Patient-Directed Discharge in People with Injection-Related Infections.Journal of general internal medicine · 2026Article
- The Impact of MOUD Initiation in Patients With Injection Drug Use-Associated Infective Endocarditis.Open forum infectious diseases · 2026Article
- Article
- Leaving against medical assumptions: reframing "AMA" discharges in the care of people who use drugs.CJEM · 2026Article
- Clinical Impact of an Expanded MOUD Access Initiative for Patients Hospitalized With Infections From Intravenous Opioid Use.American journal of medicine open · 2025Article
- Partial Oral Versus Intravenous Antibiotic Therapy for Endocarditis With Management by a Multidisciplinary Team: A Retrospective Cohort Study.Open forum infectious diseases · 2025Article
- Bacterial and fungal infections in persons who inject drugs.Clinical microbiology reviews · 2025Review
- Readmissions and Mortality After "Before Medically Advised" Hospital Discharges Among Medicare Beneficiaries with Opioid Use Disorder.Journal of general internal medicine · 2025Article
- The New Reality of Infective Endocarditis: Changes in Patient Demographics and Outcomes in South Carolina.Infectious disease reports · 2025Article
- Medications for opioid use disorder associated with reduced readmissions for patients with severe injection-related infections: A matched cohort study.Journal of substance use and addiction treatment · 2024Article
- Opportunities to improve opioid use disorder care for hospitalised patients with endocarditis.BMJ open quality · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundHospitalizations for infective endocarditis (IE) associated with opioid use disorder (O-IE) have increased in the USA and have been linked to high rates of discharge against medical advice (DAMA). DAMA represents a truncation of care for a severe infection, yet patient outcomes after DAMA are unknown.
objectiveThis study aimed to assess readmissions following O-IE and quantify the impact of DAMA on outcomes.
designA retrospective study of a nationally representative dataset of persons' inpatient discharges in the USA in 2016
participantsA total of 6018 weighted persons were discharged for O-IE, stratified by DAMA vs. other discharge statuses. Of these, 1331 (22%) were DAMA. MAIN MEASURES: The primary outcome of interest was 30-day readmission rates, stratified by discharge type. We also examined the total number of hospitalizations during the year and estimated the effect of DAMA on readmission. KEY
resultsCompared with non-DAMA, those experiencing DAMA were more commonly female, resided in metropolitan areas, lower income, and uninsured. Crude 30-day readmission following DAMA was 50%, compared with 21% for other discharge types. DAMA was strongly associated with readmission in an adjusted logistic regression model (OR 3.72, CI 3.02-4.60). Persons experiencing DAMA more commonly had ≥2 more hospitalizations during the period (31% vs. 18%, p<0.01), and were less frequently readmitted at the same hospital (49% vs 64%, p<0.01).
conclusionsDAMA occurs in nearly a quarter of patients hospitalized for O-IE and is strongly associated with short-term readmission. Interventions to address the root causes of premature discharges will enhance O-IE care, reduce hospitalizations and improve outcomes.
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Registered trials
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