Evidence map›Paper›PMID 41409009›Full record

ArticleCancer medicine2025

Factors Associated With Readmission to Index vs. Non-Index Hospitals After Major Cancer Surgery.

Avanish Madhavaram, Shan Wu, Danielle R Sharbaugh, Yuanbo Zhang, Jonathan G Yabes, Kathryn A Marchetti, Michael G Stencel, Kimberly J Rak, John A Lech, Emilia J Diego and 8 more

Abstract read
In one paragraph

Article in Cancer medicine, 2025. 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. Article
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

18 authors.

Avanish MadhavaramUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-3865-4491
Shan WuDivision of Health Services Research, Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Danielle R SharbaughDivision of Health Services Research, Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Yuanbo ZhangDepartment of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jonathan G YabesCenter for Research on Heath Care, Department of Medicine and Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Kathryn A MarchettiDivision of Health Services Research, Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Michael G StencelDepartment of Urology, Charleston Area Medical Center, Charleston, West Virginia, USA.
Kimberly J RakDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
John A LechUniversity of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA.
Emilia J DiegoMagee-Women's Hospital Comprehensive Breast Program, Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Pascal O ZinnDepartment of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Sarah TaylorUniversity of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA.
Rajeev DhuparDepartment of Cardiothoracic Surgery, Wake Forest School of Medicine, Winston Salem, North Carolina, USA.
Dana H BovbjergUniversity of Pittsburgh School of Medicine, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA.
Tiffany L Gary-WebbDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jeremy M KahnDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Lindsay M SabikDepartment of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-0613-4929
Bruce L JacobsDivision of Health Services Research, Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0003-1358-0764

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 R37CA262366Pennsylvania Department of Health
6 · The paper itself

Abstract

backgroundWhile receipt of surgery at regional referral centers is associated with improved perioperative outcomes, many vulnerable patients may experience barriers in accessing these hospitals. When these patients do manage to undergo surgery at referral centers, it remains unclear where they are readmitted to receive care when complications arise. Patients may be readmitted to the hospital where surgery was performed (index readmission) or to a different hospital (non-index readmission). This study examined whether factors associated with readmission to index versus non-index hospitals differ for patients undergoing surgery at referral centers compared to non-referral centers.

methodsWe used data from the Pennsylvania Cancer Registry and the Pennsylvania Health Care Cost Containment Council (PHC4) to identify patients who had major cancer surgery and were subsequently readmitted within 90 days. We fit a multivariable logistic regression model to identify factors associated with 90 day readmission to an index versus non-index hospital. We included an interaction term between referral center status and cancer type in this model.

resultsA total of 8215 patients were readmitted within 90 days of cancer surgery, of whom 78% (N = 6388) were readmitted to the index hospital. On multivariable analysis, factors associated with lower odds of index versus non-index readmission included older age, high Elixhauser comorbidity scores, and longer travel times. There was no significant difference in odds of index readmission when patients were treated at referral versus non-referral centers (OR = 0.77; 95% CI, 0.50-1.20). When assessing interactions, patients with lung cancer had lower odds of index readmission when treated at referral versus non-referral centers, relative to other cancers (OR = 0.59; 95% CI, 0.41-0.84).

conclusionsHigher clinical complexity and greater travel burdens were associated with lower odds of index readmission. Relative to other cancers, patients with lung cancer may be more likely to experience care fragmentation after undergoing surgery at a referral center.

Indexed as

HospitalsNeoplasmsPatient ReadmissionPostoperative ComplicationsAdultAgedFemaleHumansMaleMiddle AgedPennsylvaniaReferral and ConsultationRegistriesRisk Factorscancer surgerycentralizationreadmissionssurgical disparities

Identifiers

PMID41409009
PMCPMC12712393

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.