Evidence map›Paper›PMID 38982351›Full record

ArticleBMC emergency medicine2024

Prior emergency medical services utilization is a risk factor for in-hospital death among patients with substance misuse: a retrospective cohort study.

Preeti Gupta, Anoop Mayampurath, Tim Gruenloh, Madeline Oguss, Askar Safipour Afshar, Michael Spigner, Megan Gussick, Matthew Churpek, Todd Lee, Majid Afshar

Erratum issuedAbstract read
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In one paragraph

Article in BMC emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. 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. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Preeti GuptaDepartment of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI, 53726, USA.
Anoop MayampurathDepartment of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI, 53726, USA.
Tim GruenlohDepartment of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI, 53726, USA.
Madeline OgussDepartment of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI, 53726, USA.
Askar Safipour AfsharDepartment of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI, 53726, USA.
Michael SpignerDepartment of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.
Megan GussickDepartment of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.
Matthew ChurpekDepartment of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI, 53726, USA.
Todd LeeDepartment of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792, USA.
Majid AfsharDepartment of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI, 53726, USA. majid.afshar@wisc.edu.

Funding

Data Driven Strategies for Substance Misuse Identification in Hospitalized PatientsR01DA051464 · NIDA · UNIVERSITY OF WISCONSIN-MADISON · PI Majid Afshar · 2020 to 2026
$4.5M
Postdoctoral Training Program in Pulmonary and Critical Care Translational ResearchT32HL144909 · NHLBI · UNIVERSITY OF ILLINOIS AT CHICAGO · PI DUDEK, STEVEN M, FINN, PATRICIA W · 2019 to 2023
$1.3M
Using Machine Learning to Predict Clinical Deterioration in Hospitalized ChildrenK01HL148390 · NHLBI · UNIVERSITY OF WISCONSIN-MADISON · PI MAYAMPURATH, ANOOP · 2019 to 2023
$738k
NHLBI NIH HHS 5T32HL144909-04NHLBI NIH HHS K01 HL148390NHLBI NIH HHS K01HL148390NHLBI NIH HHS T32 HL144909NIDA NIH HHS R01 DA051464NIDA NIH HHS R01DA051464-S1
6 · The paper itself

Abstract

backgroundSubstance misuse poses a significant public health challenge, characterized by premature morbidity and mortality, and heightened healthcare utilization. While studies have demonstrated that previous hospitalizations and emergency department visits are associated with increased mortality in patients with substance misuse, it is unknown whether prior utilization of emergency medical service (EMS) is similarly associated with poor outcomes among this population. The objective of this study is to determine the association between EMS utilization in the 30 days before a hospitalization or emergency department visit and in-hospital outcomes among patients with substance misuse.

methodsWe conducted a retrospective analysis of adult emergency department visits and hospitalizations (referred to as a hospital encounter) between 2017 and 2021 within the Substance Misuse Data Commons, which maintains electronic health records from substance misuse patients seen at two University of Wisconsin hospitals, linked with state agency, claims, and socioeconomic datasets. Using regression models, we examined the association between EMS use and the outcomes of in-hospital death, hospital length of stay, intensive care unit (ICU) admission, and critical illness events, defined by invasive mechanical ventilation or vasoactive drug administration. Models were adjusted for age, comorbidities, initial severity of illness, substance misuse type, and socioeconomic status.

resultsAmong 19,402 encounters, individuals with substance misuse who had at least one EMS incident within 30 days of a hospital encounter experienced a higher likelihood of in-hospital mortality (OR 1.52, 95% CI [1.05 - 2.14]) compared to those without prior EMS use, after adjusting for confounders. Using EMS in the 30 days prior to an encounter was associated with a small increase in hospital length of stay but was not associated with ICU admission or critical illness events.

conclusionsIndividuals with substance misuse who have used EMS in the month preceding a hospital encounter are at an increased risk of in-hospital mortality. Enhanced monitoring of EMS users in this population could improve overall patient outcomes.

Indexed as

Emergency Medical ServicesHospital MortalitySubstance-Related DisordersAdultAgedFemaleHumansLength of StayMaleMiddle AgedRetrospective StudiesRisk FactorsWisconsinCritical IllnessData LinkageEmergency Medical ServicesEmergency Services UtilizationFacilities and Services UtilizationHealth ServicesHospital MortalitySubstance-Related Disorders

Identifiers

PMID38982351
PMCPMC11234660

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LicenceCC BY
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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.