Evidence map›Paper›PMID 39153890›Full record

ArticleUrologic oncology2024

Factors influencing readmission patterns following radical cystectomy: An analysis of social determinants and discharge outcomes.

Valentina Grajales, Jonathan Y Lin, Danielle Sharbaugh, Maria Pere, Adam Sharbaugh, David T Miller, Dan Pelzman, ZhaoJun Sun, Kirsten Y Eom, Benjamin J Davies and 3 more

Abstract read
In one paragraph

Article in Urologic oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

13 authors.

Valentina GrajalesDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address: grajalesv@gmail.com.
Jonathan Y LinDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Danielle SharbaughDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Maria PereDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Adam SharbaughDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
David T MillerDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Dan PelzmanDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
ZhaoJun SunDepartment of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Kirsten Y EomDepartment of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Benjamin J DaviesDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Jonathan G YabesDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA.
Lindsay M SabikDepartment of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Bruce L JacobsDepartment of Urology Division of Health Services Research University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.

Funding

Centralization of Cancer Care: Implications for Access, Outcomes, and DisparitiesR37CA262366 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Bruce L. Jacobs · 2022 to 2026
$3.0M
NCI NIH HHS R37 CA262366
6 · The paper itself

Abstract

INTRODUCTION AND

objectivesRadical cystectomy readmission rates remain high, with around 25% of patients readmitted to index and nonindex hospitals in 30 days. Nonindex readmissions have been associated with poorer outcomes, including longer lengths of stay and higher mortality rates. This study aimed to examine the associations of social factors (e.g., sex, race, socioeconomic status, insurance type, and resident location) on readmission to index versus nonindex hospitals and discharge disposition.

methodsWe conducted a population-based retrospective study using the Pennsylvania Cancer Registry (PCR) to identify patients diagnosed with nonmetastatic muscle-invasive bladder cancer who underwent radical cystectomy in Pennsylvania between 2010 and 2018. Readmitted patients were identified using the Pennsylvania Health Care Cost Containment Council data (PHC4). The primary outcome was readmission location (i.e., index or nonindex hospital) following radical cystectomy. We used chi-square tests for categorical variables, Wilcoxon rank sum test for continuous variables, multivariable logistic regression model to assess predictors of being readmitted to an index hospital and calculating the predicted probability of being admitted to an index hospital depending on discharge disposition.

resultsA total of 517 patients were readmitted within 30-days after radical cystectomy. The majority of readmissions were index readmissions (83%). Median readmission hospital stay was 4 days (interquartile range [IQR] 4) for index and 5 days (IQR 7) for nonindex hospitals, P = 0.01. Patients readmitted to index hospitals had fewer comorbidities (median weighted Elixhauser Comorbidity Index 2 (IQR 2)) and lived in urban areas (89%). Discharge with home care was associated with a higher odds of index readmission (odds ratio, [OR] 2.40; 95% confidence interval, [CI] 1.25-4.52).

conclusionsPatients residing in urban areas and with fewer comorbidities were more likely to be readmitted to index hospitals than nonindex hospitals. Socioeconomic status and insurance type did not correlate with the type of readmission. Finally, being discharged with home health care was found to be a predictor of readmission to an index hospital.

Indexed as

CystectomyPatient DischargePatient ReadmissionUrinary Bladder NeoplasmsAgedFemaleHumansMaleMiddle AgedRetrospective StudiesSocial Determinants of HealthCystectomyHealth services research, Pennsylvania, Discharge dispositionIndex hospitalNonindex hospitalReadmissions

Identifiers

PMID39153890
PMCPMC11583962

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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.