Evidence map›Paper›PMID 38240207›Full record

ArticleJournal of the American Heart Association2024

Treatment Variability Among Patients Hospitalized for Chronic Limb-Threatening Ischemia: An Analysis of the 2016 to 2018 US National Inpatient Sample.

Katelyn M Foley, Kevin F Kennedy, Fabio V Lima, Eric A Secemsky, Subhash Banerjee, Philip P Goodney, Mehdi H Shishehbor, Peter A Soukas, Omar N Hyder, J Dawn Abbott and 1 more

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Review
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

11 authors.

Katelyn M FoleyLifespan Cardiovascular Institute, Warren Alpert Medical School of Brown University Providence RI.ORCID 0009-0004-9551-5572
Kevin F KennedyStatistical Consultant Kansas City MO.
Fabio V LimaUniversity of California, San Francisco San Francisco CA.ORCID 0000-0001-8408-6902
Eric A SecemskyBeth Israel Deaconess Medical Center Boston MA.ORCID 0000-0003-3861-3163
Subhash BanerjeeBaylor Scott & White Cardiology Consultants of Texas - Dallas Dallas TX.ORCID 0000-0003-0863-7914
Philip P GoodneyDartmouth Hitchcock Medical Center Lebanon NH.ORCID 0000-0002-3973-3506
Mehdi H ShishehborHarrington Heart and Vascular Institute, University Hospitals Cleveland OH.ORCID 0000-0002-4888-2431
Peter A SoukasLifespan Cardiovascular Institute, Warren Alpert Medical School of Brown University Providence RI.ORCID 0000-0003-0402-3552
Omar N HyderLifespan Cardiovascular Institute, Warren Alpert Medical School of Brown University Providence RI.ORCID 0009-0001-0177-8995
J Dawn AbbottLifespan Cardiovascular Institute, Warren Alpert Medical School of Brown University Providence RI.ORCID 0000-0002-2560-0155
Herbert D AronowHenry Ford Health Detroit MI.ORCID 0000-0002-9061-7893

Funding

Shared Decision-Making to Improve the Health Status of Patients with Claudication: Developing and Implementing Strategies to Individualize Treatment DecisionsK23HL150290 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SECEMSKY, ERIC ALEXANDER · 2020 to 2024
$851k
NHLBI NIH HHS K23 HL150290
6 · The paper itself

Abstract

backgroundLittle is known about treatment variability across US hospitals for patients with chronic limb-threatening ischemia (CLTI). METHODS AND

resultsData were collected from the 2016 to 2018 National Inpatient Sample. All patients aged ≥18 years, admitted to nonfederal US hospitals with a primary diagnosis of CLTI, were identified. Patients were classified according to their clinical presentation (rest pain, skin ulceration, or gangrene) and were further characterized according to the treatment strategy used. The primary outcome of interest was variability in CLTI treatment, as characterized by the median odds ratio. The median odds ratio is defined as the likelihood that 2 similar patients would be treated with a given modality at 1 versus another randomly selected hospital. There were 15 896 (weighted n=79 480) hospitalizations identified where CLTI was the primary diagnosis. Medical therapy alone, endovascular revascularization ± amputation, surgical revascularization ± amputation, and amputation alone were used in 4057 (25%), 5390 (34%), 3733 (24%), and 2716 (17%) patients, respectively. After adjusting for both patient- and hospital-related factors, the median odds ratio (95% CI) for medical therapy alone, endovascular revascularization ± amputation, surgical revascularization ± amputation, any revascularization, and amputation alone were 1.28 (1.19-1.38), 1.86 (1.77-1.95), 1.65 (1.55-1.74), 1.37 (1.28-1.45), and 1.42 (1.27-1.55), respectively.

conclusionsSignificant variability in CLTI treatment exists across US hospitals and is not fully explained by patient or hospital characteristics.

Indexed as

Endovascular ProceduresPeripheral Arterial DiseaseAdolescentAdultChronic DiseaseChronic Limb-Threatening IschemiaHumansInpatientsIschemiaLimb SalvageRetrospective StudiesRisk FactorsTreatment Outcomeamputationchronic limb‐threatening ischemiacritical limb ischemiaendovascularsurgical bypasstreatment variability

Identifiers

PMID38240207
PMCPMC11056168

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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.