Predictors of In-Hospital vs Postdischarge Mortality in Pneumonia

Metersky, Mark L.; Waterer, Grant; Nsa, Wato; Bratzler, Dale W.

doi:10.1378/chest.11-2393

Cited by 61 publications

(47 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Two new scoring categories have since been proposed, extending the age and urea criteria to ≥85 years and ≥11 mmol/L, respectively, and with each scoring two points. Both cut-off points are considered to correlate with mortality 9 16 25. Extending the already adopted urea and age criteria allows a simple transition towards the use of the CURB-age score.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Short-term mortality of adult inpatients with community-acquired pneumonia: external validation of a modified CURB-65 score

Pflug¹,

Tiutan

Wesemann

et al. 2015

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…This score variant was named CURB-age. The cut-off for the urea criterion has recently been confirmed to be significant in determining prognosis 16. There has only been one validation study for the CURB-age score, which was performed by the research group that devised it 8.…”

Section: Introductionmentioning

confidence: 99%

Short-term mortality of adult inpatients with community-acquired pneumonia: external validation of a modified CURB-65 score

Pflug¹,

Tiutan

Wesemann

et al. 2015

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

“…13 14 A recent study by Yu et al (2011) showed that for certain surgical procedures approximately a quarter of postoperative deaths occurred after discharge and that 12% took place just one day after discharge from hospital. 15 Metersky et al (2012) concluded that approximately 50% of older patients who died from pneumonia within 30 days of admission did not die in hospital but after discharge. 16 We will refer to this phenomenon as "early post-discharge mortality."…”

Section: Introductionmentioning

confidence: 99%

Including post-discharge mortality in calculation of hospital standardised mortality ratios: retrospective analysis of hospital episode statistics

Pouw

Peelen

Moons

et al. 2013

BMJ

View full text Add to dashboard Cite

Objectives To assess the consequences of applying different mortality timeframes on standardised mortality ratios of individual hospitals and, secondarily, to evaluate the association between in-hospital standardised mortality ratios and early post-discharge mortality rate, length of hospital stay, and transfer rate.Design Retrospective analysis of routinely collected hospital data to compare observed deaths in 50 diagnostic categories with deaths predicted by a case mix adjustment method. Main outcome measuresIn-hospital standardised mortality ratio, 30 days post-admission standardised mortality ratio, and 30 days post-discharge standardised mortality ratio.Results Compared with the in-hospital standardised mortality ratio, 33% of the hospitals were categorised differently with the 30 days post-admission standardised mortality ratio and 22% were categorised differently with the 30 days post-discharge standardised mortality ratio.A positive association was found between in-hospital standardised mortality ratio and length of hospital stay (Pearson correlation coefficient 0.33; P=0.01), and an inverse association was found between in-hospital standardised mortality ratio and early post-discharge mortality (Pearson correlation coefficient −0.37; P=0.004). ConclusionsApplying different mortality timeframes resulted in differences in standardised mortality ratios and differences in judgment regarding the performance of individual hospitals. Furthermore, associations between in-hospital standardised mortality rates, length of stay, and early post-discharge mortality rates were found. Combining these findings suggests that standardised mortality ratios based on in-hospital mortality are subject to so-called "discharge bias." Hence, early post-discharge mortality should be included in the calculation of standardised mortality ratios. IntroductionIn the past few decades, quality of care in hospitals has been subject to growing attention from physicians and regulators. In various countries, standardised mortality ratios are used in an

show abstract

“…[40,41] Nationally in the U.S., hospital readmission for PN continues to be financially penalized. [1][2][3] Nursing and hospital leadership must under-stand that within multifactorial transitions, CS may play a part in readmission reduction.…”

Section: Discussionmentioning

confidence: 99%

Framed messages effects on readmissions

Halpin

Hodge

2016

JHA

View full text Add to dashboard Cite

Objective: As the eighth leading cause of death in the US, pneumonia (PN) is relevant to the health of the elderly and young. Accountability for readmission is part of the Affordable Care Act's Hospital Readmissions Reduction Program (RRP), which levies penalties for readmissions. We examined communication using framing effects which can motivate patients' decisions collaboratively with providers for post discharge care and readmissions prevention. Communication strategies (CS) can facilitate decision-making (DM) about health care choices. The project's aims were to (1) compare CS of framing effects (positive or negative messages) on the readmission outcome 30 days post discharge; (2) assess PN readmissions decrease 30 days post discharge when CS include the patient/family in decisions about transitions; (3) determine the impact of between patients and HCPs agreement for post hospital care, and (4) examine confounding effects between framing effects and readmission rates of age, PN severity index (PSI), and the number of diagnoses. Methods: A double-blind randomized control trial (RCT) used parallel assignment of 153 PN patients to one of three arms to test the communication framing effects using power analysis, odds ratio, Fischer's exact and ANOVA. Arm A was the Intervention positive framing group (n = 44), arm B was the Intervention Negative framing group (n = 65), and arm C was the control group (n = 44). Conclusions: Findings suggest that framed messages aid in the reduction of PN readmission rates in hospitals. DM strategies incorporates education and understanding of risk by the patient, so the healthcare teams can encourage and improve readmission outcomes.

show abstract

Predictors of In-Hospital vs Postdischarge Mortality in Pneumonia

Cited by 61 publications

References 12 publications

Short-term mortality of adult inpatients with community-acquired pneumonia: external validation of a modified CURB-65 score

Short-term mortality of adult inpatients with community-acquired pneumonia: external validation of a modified CURB-65 score

Including post-discharge mortality in calculation of hospital standardised mortality ratios: retrospective analysis of hospital episode statistics

Framed messages effects on readmissions

Contact Info

Product

Resources

About