2024
Natural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure
Adejumo P, Thangaraj P, Dhingra L, Aminorroaya A, Zhou X, Brandt C, Xu H, Krumholz H, Khera R. Natural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure. JAMA Network Open 2024, 7: e2443925. PMID: 39509128, PMCID: PMC11544492, DOI: 10.1001/jamanetworkopen.2024.43925.Peer-Reviewed Original ResearchConceptsFunctional status assessmentArea under the receiver operating characteristic curveClinical documentationElectronic health record dataHF symptomsOptimal care deliveryHealth record dataAssess functional statusStatus assessmentClinical trial participationProcessing of clinical documentsFunctional status groupCare deliveryOutpatient careMain OutcomesMedical notesTrial participantsNew York Heart AssociationFunctional statusQuality improvementRecord dataHeart failureClinical notesDiagnostic studiesStatus groupsIschemic Stroke and Reduced Left Ventricular Ejection Fraction: A Multidisciplinary Approach to Optimize Brain and Cardiac Health
McNamara K, Merkler A, Freeman J, Krumholz H, Ahmad T, Sharma R. Ischemic Stroke and Reduced Left Ventricular Ejection Fraction: A Multidisciplinary Approach to Optimize Brain and Cardiac Health. Stroke 2024, 55: 1720-1727. PMID: 38660813, DOI: 10.1161/strokeaha.123.045623.Peer-Reviewed Original ResearchMeSH KeywordsBrainHeart FailureHumansIschemic StrokeStrokeStroke VolumeVentricular Dysfunction, LeftConceptsReduced left ventricular ejection fractionLeft ventricular ejection fractionIschemic strokeVentricular ejection fractionAdverse cardiac outcomesRecurrent acute ischemic strokeAcute ischemic stroke hospitalizationsIschemic stroke hospitalizationsAcute ischemic strokeCardiac healthEjection fractionCardiac outcomesStroke hospitalizationsRisk factorsCare paradigmOptimal brainMultidisciplinary approachHealthBrain
2023
Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
Wang Y, Eldridge N, Metersky M, Rodrick D, Eckenrode S, Mathew J, Galusha D, Peterson A, Hunt D, Normand S, Krumholz H. Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009573. PMID: 37463255, PMCID: PMC10351904, DOI: 10.1161/circoutcomes.122.009573.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesHeart FailureHospital MortalityHospitalsHumansMedicarePatient ReadmissionUnited StatesConceptsMore adverse eventsAdverse eventsHeart failureCause mortalityReadmission ratesHigh riskMedicare Patient Safety Monitoring SystemHospital-acquired adverse eventsIn-Hospital Adverse EventsHospital adverse eventsRate of patientsPatient Safety DatabasePerformance categoriesAdverse event dataCross-sectional studyUnited States CentersHospital performanceHospital characteristicsReadmission dataPatient riskMAIN OUTCOMEPatientsWorst hospitalsHospitalHigh mortalityOpportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction
Swat S, Xu H, Allen L, Greene S, DeVore A, Matsouaka R, Goyal P, Peterson P, Hernandez A, Krumholz H, Yancy C, Fonarow G, Hess P, Program A. Opportunities and Achievement of Medication Initiation Among Inpatients With Heart Failure With Reduced Ejection Fraction. JACC Heart Failure 2023, 11: 918-929. PMID: 37318420, DOI: 10.1016/j.jchf.2023.04.015.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityFemaleHeart FailureHospitalizationHumansInpatientsStroke VolumeVentricular Dysfunction, LeftConceptsEvidence-based medicationsMedication initiationReduced ejection fractionNumber of medicationsMultivariable logistic regressionNumber of patientsPre-existing conditionsReduced ejectionEjection fractionHeart failureMultivariable analysisFemale sexLower oddsMedicationsMean net gainPatientsRural hospitalsAdmissionOlder ageLogistic regressionStudy periodMean numberOddsInitiationRural locationsAssociation of Beta-Blocker Therapy With Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease
Godoy L, Farkouh M, Austin P, Shah B, Qiu F, Jackevicius C, Wijeysundera H, Krumholz H, Ko D. Association of Beta-Blocker Therapy With Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease. Journal Of The American College Of Cardiology 2023, 81: 2299-2311. PMID: 37316110, DOI: 10.1016/j.jacc.2023.04.021.Peer-Reviewed Original ResearchConceptsStable coronary artery diseaseCoronary artery diseaseBeta-blocker groupRecent myocardial infarctionHeart failureMyocardial infarctionCardiovascular eventsCoronary angiographyPrescription claimsObstructive coronary artery diseaseIndex coronary angiographyBeta-blocker therapyBeta-blocker useHeart failure hospitalizationElective coronary angiographyNew-user designMyocardial infarction hospitalizationsCause deathCardiovascular outcomesCause mortalityFailure hospitalizationCardioprotective benefitsArtery diseasePrimary outcomeIschemic heartIn-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility
Ivey-Miranda J, Rao V, Cox Z, Moreno-Villagomez J, Mahoney D, Maulion C, Bellumkonda L, Turner J, Collins S, Wilson F, Krumholz H, Testani J. In-Hospital Observation on Oral Diuretics After Treatment for Acute Decompensated Heart Failure: Evaluating the Utility. Circulation Heart Failure 2023, 16: e010206. PMID: 36896716, PMCID: PMC10186250, DOI: 10.1161/circheartfailure.122.010206.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureDiuretic responseDiuretic dosingOral diureticsHeart failureMulticenter cohortHospital observationLower readmission ratesNet fluid balanceDays postdischargeReadmission ratesHospital readmissionUrine outputReadmission riskFluid statusFluid balanceHospital measuresDose selectionCohortProvider decisionsWeight changeReadmissionDiureticsPatients
2022
Temporal trends in postoperative and ventilator-associated pneumonia in the United States
Metersky M, Wang Y, Klompas M, Eckenrode S, Mathew J, Krumholz H. Temporal trends in postoperative and ventilator-associated pneumonia in the United States. Infection Control And Hospital Epidemiology 2022, 44: 1247-1254. PMID: 36326283, DOI: 10.1017/ice.2022.264.Peer-Reviewed Original ResearchConceptsVentilator-associated pneumoniaMajor surgical proceduresPostoperative pneumoniaAcute myocardial infarctionSurgical proceduresHeart failureMyocardial infarctionMedicare Patient Safety Monitoring SystemAnnual riskRetrospective cohort studyPrior yearRisk-adjusted ratesAdverse event measuresCohort studyRetrospective reviewPneumoniaPatientsInfarctionUnited StatesRiskSignificant changesYearsTemporal trendsFailureHospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study
Yu Y, Guan W, Masoudi FA, Wang B, He G, Spertus JA, Lu Y, Krumholz HM, Li J. Hospital Variation of Spironolactone Use in Patients Hospitalized for Heart Failure in China—The China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2022, 11: e026300. PMID: 36172964, PMCID: PMC9673705, DOI: 10.1161/jaha.122.026300.Peer-Reviewed Original ResearchConceptsSpironolactone prescriptionSpironolactone useHeart failureMedian odds ratioIdeal patientAldosterone antagonistsHospital variationMedian rateReduced ejection fractionUse of spironolactoneMultivariable linear regression modelsHeart Failure StudyEjection fractionHospital characteristicsOdds ratioRepresentative cohortPatientsHospitalChinese hospitalsInappropriate usePrescriptionSpironolactoneSelect individualsAntagonistHigh rateTrends in Adverse Event Rates in Hospitalized Patients, 2010-2019
Eldridge N, Wang Y, Metersky M, Eckenrode S, Mathew J, Sonnenfeld N, Perdue-Puli J, Hunt D, Brady PJ, McGann P, Grace E, Rodrick D, Drye E, Krumholz HM. Trends in Adverse Event Rates in Hospitalized Patients, 2010-2019. JAMA 2022, 328: 173-183. PMID: 35819424, PMCID: PMC9277501, DOI: 10.1001/jama.2022.9600.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAdultAgedAged, 80 and overCross InfectionCross-Sectional StudiesDrug-Related Side Effects and Adverse ReactionsFemaleHeart FailureHospitalizationHumansMaleMedicareMiddle AgedMyocardial InfarctionPatient SafetyPneumoniaPostoperative ComplicationsPressure UlcerRisk AssessmentSurgical Procedures, OperativeUnited StatesConceptsMajor surgical proceduresAcute myocardial infarctionAdverse event ratesGeneral adverse eventsAdverse eventsHeart failureAdverse drug eventsAcute care hospitalsMyocardial infarctionHospital-acquired infectionsSurgical proceduresEvent ratesHospital dischargeCare hospitalDrug eventsMedicare Patient Safety Monitoring SystemSerial cross-sectional studyPatient safetyUS acute care hospitalsHospital adverse eventsSignificant decreaseSurgical procedure groupsCross-sectional studyRisk-adjusted ratesAdult patientsAssociation of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study
Abdel-Qadir H, Akioyamen LE, Fang J, Pang A, Ha ACT, Jackevicius CA, Alter DA, Austin PC, Atzema CL, Bhatia RS, Booth GL, Johnston S, Dhalla I, Kapral MK, Krumholz HM, McNaughton CD, Roifman I, Tu K, Udell JA, Wijeysundera HC, Ko DT, Schull MJ, Lee DS. Association of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study. Circulation 2022, 146: 159-171. PMID: 35678171, PMCID: PMC9287095, DOI: 10.1161/circulationaha.122.058949.Peer-Reviewed Original ResearchConceptsYears of ageCohort studyUniversal health careAF-related adverse eventsNeighbourhood-level material deprivationPopulation-based cohort studyPrimary care physician visitsCause-specific hazards regressionRhythm control interventionsHigh cardiovascular disease burdenCardiovascular disease burdenHealth careAtrial fibrillation careNeighborhood material deprivationSingle-payer health care systemMaterial deprivation quintileAtrial fibrillation diagnosisHealth care systemNoncardiovascular comorbiditiesAdverse eventsHeart failurePhysician visitsHazards regressionAdverse outcomesDeprivation quintileCardiac Status Among Heart Failure Patients With Implantable Cardioverter Defibrillators Before, During, and After COVID-19 Lockdown
Lu Y, Jones PW, Murugiah K, Caraballo C, Mahajan S, Massey D, Ahmed R, Bader E, Krumholz H. Cardiac Status Among Heart Failure Patients With Implantable Cardioverter Defibrillators Before, During, and After COVID-19 Lockdown. Journal Of Cardiac Failure 2022, 28: 1372-1374. PMID: 35690314, PMCID: PMC9187866, DOI: 10.1016/j.cardfail.2022.05.012.Peer-Reviewed Original ResearchConceptsImplantable cardioverter defibrillatorHeart failure patientsCRT-D devicesCardiac statusFailure patientsHeart failureCardioverter defibrillatorCardiac resynchronization therapy defibrillatorAcute cardiac conditionsMedical care deliveryInpatient careCardiac conditionsPhysiologic markersInpatient servicesPatientsCardiac healthCare deliveryMarked restrictionImplanted ICDsMinneapolis/Saint PaulSex subgroupsDefibrillatorCOVID-19Telemedicine servicesCOVID-19 lockdown
2021
Prior Authorization, Copayments, and Utilization of Sacubitril/Valsartan in Medicare and Commercial Plans in Patients With Heart Failure With Reduced Ejection Fraction
Ozaki AF, Krumholz HM, Mody FV, Tran TT, Le QT, Yokota M, Jackevicius CA. Prior Authorization, Copayments, and Utilization of Sacubitril/Valsartan in Medicare and Commercial Plans in Patients With Heart Failure With Reduced Ejection Fraction. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007665. PMID: 34465124, DOI: 10.1161/circoutcomes.120.007665.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanSacubitril/valsartan useInsurance plan typeReduced ejection fractionHeart failureEjection fractionValsartan useCommercial plansNew York Heart Association classPA criteriaReduced ejection fraction patientsReduced ejection fraction populationPlan typeEjection fraction patientsMedicare plansEjection fraction populationCross-sectional studyProportion of plansPrescription copaymentsAssociation classCopayment amountPrimary outcomeClinical outcomesPlan populationMore prescriptionsNational Trends in the Use of Sacubitril/Valsartan
Ozaki AF, Krumholz HM, Mody FV, Jackevicius CA. National Trends in the Use of Sacubitril/Valsartan. Journal Of Cardiac Failure 2021, 27: 839-847. PMID: 34364661, DOI: 10.1016/j.cardfail.2021.05.015.Peer-Reviewed Original ResearchConceptsSacubitril/valsartanSacubitril/valsartan useReduced ejection fractionValsartan useEjection fractionHeart failurePopulation-level cohort studyNational Prescription AuditEligible patientsCohort studyPrescription patternsYounger patientsPrescription auditDosage patternClinical implicationsFurther evaluationValsartanPatientsSubstantial proportionNational trendsPrescriptionGreater increaseRecent useGreater proportionUnited StatesOut‐of‐pocket Annual Health Expenditures and Financial Toxicity from Healthcare Costs in Patients with Heart Failure in the United States
Wang SY, Valero‐Elizondo J, Ali H, Pandey A, Cainzos‐Achirica M, Krumholz HM, Nasir K, Khera R. Out‐of‐pocket Annual Health Expenditures and Financial Toxicity from Healthcare Costs in Patients with Heart Failure in the United States. Journal Of The American Heart Association 2021, 10: e022164. PMID: 33998273, PMCID: PMC8483501, DOI: 10.1161/jaha.121.022164.Peer-Reviewed Original ResearchConceptsGreater risk-adjusted oddsRisk-adjusted oddsHeart failureMedical Expenditure Panel SurveyCatastrophic financial burdenPocket healthcare expensesHigh financial burdenFinancial toxicityHealthcare expensesFinancial burdenHealthcare costsCatastrophic burdenMajor public health burdenLow-income familiesBackground Heart failurePublic health burdenInsurance premiumsPanel SurveyPocket healthcare costsAnnual health expenditureWorld Health OrganizationConclusions PatientsHealth insurance premiumsPocket healthcare expenditureHealth burdenIncorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models
Triche EW, Xin X, Stackland S, Purvis D, Harris A, Yu H, Grady JN, Li SX, Bernheim SM, Krumholz HM, Poyer J, Dorsey K. Incorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models. JAMA Network Open 2021, 4: e218512. PMID: 33978722, PMCID: PMC8116982, DOI: 10.1001/jamanetworkopen.2021.8512.Peer-Reviewed Original ResearchConceptsPOA indicatorRisk factorsOutcome measuresQuality outcome measuresRisk-adjustment modelsClaims dataAdmission indicatorsPatient risk factorsAcute myocardial infarctionPatient-level outcomesAdministrative claims dataQuality improvement studyClaims-based measuresComparative effectiveness studiesPatient claims dataInternational Statistical ClassificationMortality outcome measuresRelated Health ProblemsHospital quality measuresRisk model performanceHospital stayIndex admissionCare algorithmHeart failureMortality outcomes
2020
From Reactivity to Proactivity On the Path to Pre-Empting Heart Failure Hospitalizations ∗
Desai NR, Krumholz HM. From Reactivity to Proactivity On the Path to Pre-Empting Heart Failure Hospitalizations ∗. JACC Heart Failure 2020, 8: 1035-1037. PMID: 33189634, DOI: 10.1016/j.jchf.2020.09.007.Peer-Reviewed Original ResearchFrequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand
Labrosciano C, Horton D, Air T, Tavella R, Beltrame JF, Zeitz CJ, Krumholz HM, Adams R, Scott IA, Gallagher M, Hossain S, Hariharaputhiran S, Ranasinghe I. Frequency, trends and institutional variation in 30‐day all‐cause mortality and unplanned readmissions following hospitalisation for heart failure in Australia and New Zealand. European Journal Of Heart Failure 2020, 23: 31-40. PMID: 33094886, DOI: 10.1002/ejhf.2030.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAustraliaFemaleHeart FailureHospitalizationHumansMaleNew ZealandPatient ReadmissionConceptsHF hospitalisationUnplanned readmissionReadmission ratesHeart failure hospitalisationUnplanned readmission rateMortality cohortReadmission cohortCause mortalityHeart failurePrimary outcomeHospitalisationReadmissionSeparate cohortMortality rateHospitalPatientsMortalityCare qualityPrivate hospitalsStudy periodCohortModest declineNational averageOutcomesDaysEvaluation of Case Volumes of a Heart Transplant Program and Short-term Outcomes After Changes in the United Network for Organ Sharing Donor Heart Allocation System
Mori M, Wilson L, Ali A, Ahmad T, Anwer M, Jacoby D, Geirsson A, Krumholz HM. Evaluation of Case Volumes of a Heart Transplant Program and Short-term Outcomes After Changes in the United Network for Organ Sharing Donor Heart Allocation System. JAMA Network Open 2020, 3: e2017513. PMID: 32945877, PMCID: PMC7501535, DOI: 10.1001/jamanetworkopen.2020.17513.Peer-Reviewed Original ResearchConceptsYale-New Haven HospitalHeart transplant programShort-term outcomesHeart transplantHeart transplant volumeNew Haven HospitalDonor heartsPatient selectionRecipient selectionTransplant programsTransplant volumeWaiting listCase volumeDonor heart allocation systemPre-post cohort studyConservative patient selectionUnused donor heartsHeart allocation systemHigher median numberCirculatory assist devicesCohort studyPatient characteristicsMore patientsSingle centerCenter volumeTimely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data
Li SX, Wang Y, Lama SD, Schwartz J, Herrin J, Mei H, Lin Z, Bernheim SM, Spivack S, Krumholz HM, Suter LG. Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data. BMC Health Services Research 2020, 20: 733. PMID: 32778098, PMCID: PMC7416804, DOI: 10.1186/s12913-020-05611-w.Peer-Reviewed Original ResearchAssociation Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States
Wang Y, Eldridge N, Metersky ML, Sonnenfeld N, Rodrick D, Fine JM, Eckenrode S, Galusha DH, Tasimi A, Hunt DR, Bernheim SM, Normand ST, Krumholz HM. Association Between Medicare Expenditures and Adverse Events for Patients With Acute Myocardial Infarction, Heart Failure, or Pneumonia in the United States. JAMA Network Open 2020, 3: e202142. PMID: 32259263, PMCID: PMC7139276, DOI: 10.1001/jamanetworkopen.2020.2142.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMedicare Patient Safety Monitoring SystemAdverse event ratesAdverse eventsHeart failureMedicare expendituresService patientsMyocardial infarctionMedicare feeEvent ratesHigher adverse event ratesCare expendituresRisk-standardized ratesPatients 65 yearsAdverse event dataAcute care hospitalsCross-sectional studyFinal study sampleInpatient care expendituresRate of occurrenceDates of analysisPatient characteristicsCare hospitalMean ageInpatient care