2024
Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing
Nargesi A, Adejumo P, Dhingra L, Rosand B, Hengartner A, Coppi A, Benigeri S, Sen S, Ahmad T, Nadkarni G, Lin Z, Ahmad F, Krumholz H, Khera R. Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing. JACC Heart Failure 2024 PMID: 39453355, DOI: 10.1016/j.jchf.2024.08.012.Peer-Reviewed Original ResearchReduced ejection fractionEjection fractionHeart failureLeft ventricular ejection fractionVentricular ejection fractionYale-New Haven HospitalIdentification of patientsCommunity hospitalIdentification of heart failureLanguage modelNorthwestern MedicineMeasure care qualityQuality of careNew Haven HospitalDeep learning-based natural language processingHFrEFGuideline-directed careDeep learning language modelsMIMIC-IIIDetect HFrEFNatural language processingReclassification improvementHospital dischargePatientsCare qualityAssociation of marital/partner status with hospital readmission among young adults with acute myocardial infarction.
Zhu C, Dreyer R, Li F, Spatz E, Caraballo C, Mahajan S, Raparelli V, Leifheit E, Lu Y, Krumholz H, Spertus J, D'Onofrio G, Pilote L, Lichtman J. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLOS ONE 2024, 19: e0287949. PMID: 38277368, PMCID: PMC10817183, DOI: 10.1371/journal.pone.0287949.Peer-Reviewed Original ResearchConceptsMarital/partner statusPsychosocial factorsAcute myocardial infarctionYoung adultsHospital dischargeYear of hospital dischargeYoung acute myocardial infarctionAssociated with 1.3-foldCohort of young adultsLong-term readmissionCox proportional hazards modelsStatus interactionSimilar-aged menMyocardial infarctionProportional hazards modelUnpartnered statusPatient interviewsPhysician panelCardiovascular healthHospital readmissionSocioeconomic factorsAMI survivorsSequential adjustmentCardiac readmissionMultiple imputation
2023
Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System
Akioyamen L, Abdel-Qadir H, Han L, Sud M, Mistry N, Alter D, Atzema C, Austin P, Bhatia R, Booth G, Dhalla I, Ha A, Jackevicius C, Kapral M, Krumholz H, Lee D, McNaughton C, Roifman I, Schull M, Sivaswamy A, Tu K, Udell J, Wijeysundera H, Ko D. Association of Neighborhood-Level Marginalization With Health Care Use and Clinical Outcomes Following Hospital Discharge in Patients Who Underwent Coronary Catheterization for Acute Myocardial Infarction in a Single-Payer Health Care System. Circulation Cardiovascular Quality And Outcomes 2023, 16: e010063. PMID: 38050754, DOI: 10.1161/circoutcomes.123.010063.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHealth care systemHospital dischargeClinical outcomesSocioeconomic statusFirst acute myocardial infarctionProportional hazards regression modelsCare systemSecondary prevention medicationsWorse clinical outcomesHealth service usePopulation-based studyPrimary care physiciansHealth care useHazards regression modelsGreater long-term riskPrescription medication useSingle-payer health care systemUniversal health care systemLong-term riskLow socioeconomic statusCause mortalityDays postdischargePrevention medications
2022
Trends 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 patientsInstitutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation
Ngo L, Ali A, Ganesan A, Woodman R, Krumholz HM, Adams R, Ranasinghe I. Institutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation. Journal Of The American Heart Association 2022, 11: e022009. PMID: 35156395, PMCID: PMC9245833, DOI: 10.1161/jaha.121.022009.Peer-Reviewed Original ResearchConceptsProcedure-related complicationsComplication rateAF ablationAtrial fibrillationCatheter ablationStroke/transient ischemic attackCare qualityTransient ischemic attackRisk of complicationsIschemic attackHospital stayCohort studyCommon complicationHospital dischargePericardial effusionCardiorespiratory failurePrimary outcomeProcedural characteristicsComplicationsPatientsHospitalStudy periodBackground ComplicationsPotential disparitiesFibrillation
2021
Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial
Bikdeli B, Talasaz AH, Rashidi F, Bakhshandeh H, Rafiee F, Rezaeifar P, Baghizadeh E, Matin S, Jamalkhani S, Tahamtan O, Sharif-Kashani B, Beigmohammadi MT, Farrokhpour M, Sezavar SH, Payandemehr P, Dabbagh A, Moghadam KG, Khalili H, Yadollahzadeh M, Riahi T, Abedini A, Lookzadeh S, Rahmani H, Zoghi E, Mohammadi K, Sadeghipour P, Abri H, Tabrizi S, Mousavian SM, Shahmirzaei S, Amin A, Mohebbi B, Parhizgar SE, Aliannejad R, Eslami V, Kashefizadeh A, Dobesh PP, Kakavand H, Hosseini SH, Shafaghi S, Ghazi SF, Najafi A, Jimenez D, Gupta A, Madhavan MV, Sethi SS, Parikh SA, Monreal M, Hadavand N, Hajighasemi A, Maleki M, Sadeghian S, Piazza G, Kirtane AJ, Van Tassell BW, Stone GW, Lip GYH, Krumholz H, Goldhaber SZ, Sadeghipour P. Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial. Thrombosis And Haemostasis 2021, 122: 131-141. PMID: 33865239, DOI: 10.1055/a-1485-2372.Peer-Reviewed Original ResearchConceptsStandard-dose prophylactic anticoagulationExtracorporeal membrane oxygenationProphylactic anticoagulationIntermediate doseEfficacy outcomesArterial thrombosisCOVID-19Hospital discharge statusMain safety outcomeProphylactic antithrombotic therapyComposite of deathCritically Ill PatientsPrimary efficacy outcomeStandard-dose groupIntermediate-dose groupIntensive care unitCoronavirus disease 2019Cause deathMajor bleedingModified intentionOpen labelAntithrombotic therapyExtrapulmonary manifestationsHospital dischargeThrombotic complications
2020
Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017
Mori M, Wang Y, Murugiah K, Khera R, Gupta A, Vallabhajosyula P, Masoudi FA, Geirsson A, Krumholz HM. Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017. Journal Of The American Heart Association 2020, 9: e016980. PMID: 33045889, PMCID: PMC7763387, DOI: 10.1161/jaha.120.016980.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryFirst-time coronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryGraft surgeryMedicare feeOlder adultsPatient baseline characteristicsData of adultsYear of dischargeProportion of womenService inpatientsIndex surgeryBaseline characteristicsHospital dischargeOlder patientsMedian agePrimary outcomeCox regressionService patientsUnique patientsPatientsSurgeryAnnual declineDemographic subgroupsProtocol for project recovery after cardiac surgery: a single-center cohort study leveraging digital platform to characterise longitudinal patient-reported postoperative recovery patterns
Mori M, Brooks C, Spatz E, Mortazavi BJ, Dhruva SS, Linderman GC, Grab LA, Zhang Y, Geirsson A, Chaudhry SI, Krumholz HM. Protocol for project recovery after cardiac surgery: a single-center cohort study leveraging digital platform to characterise longitudinal patient-reported postoperative recovery patterns. BMJ Open 2020, 10: e036959. PMID: 32873671, PMCID: PMC7467526, DOI: 10.1136/bmjopen-2020-036959.Peer-Reviewed Original ResearchConceptsPatient-reported outcome measuresCohort studyHospital dischargeCardiac surgerySingle-center cohort studyCoronary artery bypass graftIntensive care unit dischargeMedical record review dataPostoperative patient recoveryPostoperative recovery patternsArtery bypass graftProspective cohort studyGroup-based trajectory modellingMedical record reviewRecovery patternsRecord review dataHealth information exchange platformInstitutional review boardAortic surgeryHospital coursePatient demographicsPeer-reviewed journalsClinical factorsHospital readmissionOperative details
2019
Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study.
Dodson JA, Hajduk AM, Geda M, Krumholz HM, Murphy TE, Tsang S, Tinetti ME, Nanna MG, McNamara R, Gill TM, Chaudhry SI. Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study. Annals Of Internal Medicine 2019, 172: 12-21. PMID: 31816630, PMCID: PMC7695040, DOI: 10.7326/m19-0974.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI mortalityFunctional impairmentOlder adultsCohort studyMean ageMyocardial infarctionPatient-reported health statusNet reclassification improvement indexProspective cohort studyParticipants' mean ageFinal risk modelMobility impairmentsGood discriminatory abilityRisk modelChart reviewHospital dischargePrognostic utilityBlood InstituteClinical variablesNational HeartHigh prevalenceHealth statusMortalityYounger counterpartsPatient-Reported Quality of Hospital Discharge Transitions: Results from the SILVER-AMI Study
Richards BG, Hajduk AM, Perry J, Krumholz HM, Khan AM, Chaudhry SI. Patient-Reported Quality of Hospital Discharge Transitions: Results from the SILVER-AMI Study. Journal Of General Internal Medicine 2019, 35: 808-814. PMID: 31654359, PMCID: PMC7080904, DOI: 10.1007/s11606-019-05414-8.Peer-Reviewed Original ResearchConceptsDays of dischargeEmergency department utilizationAcute myocardial infarctionPatient-reported qualityHospital discharge processOlder patientsAcute Myocardial Infarction StudyMyocardial Infarction StudyProspective cohort studyMedical record reviewEmergency room utilizationAdults age 75Key ResultsA totalHospital Consumer AssessmentSILVER-AMI StudyHospital discharge transitionsHigh-risk periodDesignMulti-centerCohort studyHospital dischargeMedian ageClinical outcomesRecord reviewAdverse outcomesResultsA total
2018
Is Posthospital Syndrome a Result of Hospitalization-Induced Allostatic Overload?
Goldwater DS, Dharmarajan K, McEwan BS, Krumholz HM. Is Posthospital Syndrome a Result of Hospitalization-Induced Allostatic Overload? Journal Of Hospital Medicine 2018, 13 PMID: 29813141, DOI: 10.12788/jhm.2986.Peer-Reviewed Original ResearchConceptsPosthospital syndromeAllostatic overloadAutonomic nervous systemMultiple organ systemsHospital dischargeInflammatory markersAdverse eventsHospital readmissionAdrenal axisAdverse outcomesPlausible etiologyPathophysiologic consequencesElevated riskNervous systemNarrative reviewOrgan systemsEnhanced vulnerabilityElevated levelsHospital environmentTraditional hospital environmentSyndromeMaladaptive statesOverloadOutcomesPossible mechanismClinical Outcomes of Plavix and Generic Clopidogrel for Patients Hospitalized With an Acute Coronary Syndrome
Ko DT, Krumholz HM, Tu JV, Austin PC, Stukel TA, Koh M, Chong A, de Melo JF, Jackevicius CA. Clinical Outcomes of Plavix and Generic Clopidogrel for Patients Hospitalized With an Acute Coronary Syndrome. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004194. PMID: 29535091, DOI: 10.1161/circoutcomes.117.004194.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAged, 80 and overClopidogrelCost SavingsCost-Benefit AnalysisDatabases, FactualDrug CostsDrug SubstitutionDrugs, GenericFemaleHemorrhageHumansMaleOntarioPatient AdmissionPatient ReadmissionPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsRecurrenceRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsAcute coronary syndromeGeneric clopidogrelClinical outcomesCoronary syndromePrimary outcomeRecurrent acute coronary syndromeSubstantial healthcare cost savingsPopulation-based observational studyPropensity-weighted cohortsComposite of deathTransient ischemic attackComposite end pointEffect of clopidogrelElevation myocardial infarctionHealthcare cost savingsCox proportional hazardsRate of deathIschemic attackACS hospitalizationCause readmissionBaseline characteristicsHospital dischargeRecurrent hospitalizationsMean ageMyocardial infarction
2017
Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge
Dharmarajan K, Wang Y, Lin Z, Normand ST, Ross JS, Horwitz LI, Desai NR, Suter LG, Drye EE, Bernheim SM, Krumholz HM. Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge. JAMA 2017, 318: 270-278. PMID: 28719692, PMCID: PMC5817448, DOI: 10.1001/jama.2017.8444.Peer-Reviewed Original ResearchConceptsRisk-adjusted readmission ratesRisk-adjusted mortality ratesAcute myocardial infarctionHeart failureReadmission ratesMortality rateMyocardial infarctionMedicare feeService beneficiariesHospital readmission ratesMean hospitalHospital mortalityPostdischarge mortalityHospital dischargeHospital readmissionRetrospective studyAffordable Care ActReadmission reductionMAIN OUTCOMEPneumoniaHospitalSecondary analysisWeighted Pearson correlation coefficientMortalityCare Act
2016
Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study
Minges KE, Strait KM, Owen N, Dunstan DW, Camhi SM, Lichtman J, Geda M, Dreyer RP, Bueno H, Beltrame JF, Curtis JP, Krumholz HM. Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study. European Journal Of Preventive Cardiology 2016, 24: 192-203. PMID: 27885060, DOI: 10.1177/2047487316679905.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAustraliaCardiac RehabilitationChi-Square DistributionExerciseExercise TherapyFemaleHealth BehaviorHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMyocardial InfarctionOdds RatioPatient ComplianceProspective StudiesRisk FactorsSex FactorsSpainTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsAcute myocardial infarctionPost-acute myocardial infarctionMyocardial infarctionPhysical activityRegular physical activity participationYoung AMI Patients (VIRGO) studyPhysical activity recommendationsAmerican Heart AssociationPhysical activity trajectoriesNon-white raceMyocardial infarction recoveryPhysical activity participationGender differencesHospital dischargeHeart AssociationLifestyle behaviorsActivity recommendationsObservational studyInfarctionAustralian hospitalsTargeted interventionsOne monthPatientsTime pointsLonger durationTrajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Krumholz HM, Hsieh A, Dreyer RP, Welsh J, Desai NR, Dharmarajan K. Trajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. PLOS ONE 2016, 11: e0160492. PMID: 27716841, PMCID: PMC5055318, DOI: 10.1371/journal.pone.0160492.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRisk of readmissionHeart failureReadmission diagnosesHospital dischargeReadmission riskTiming of riskMyocardial infarctionImmediate post-discharge periodDiagnostic categoriesPhysiologic systemsRisk of rehospitalizationGeneral elderly populationRisk of deathPost-discharge periodPost-discharge interventionsTrauma/injuryHospitalization riskHospitalizationTrajectories of riskElderly populationMedicare feePneumoniaRehospitalizationService beneficiaries
2015
Medication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures
Allen LA, Fonarow GC, Liang L, Schulte PJ, Masoudi FA, Rumsfeld JS, Ho PM, Eapen ZJ, Hernandez AF, Heidenreich PA, Bhatt DL, Peterson ED, Krumholz HM. Medication Initiation Burden Required to Comply With Heart Failure Guideline Recommendations and Hospital Quality Measures. Circulation 2015, 132: 1347-1353. PMID: 26316616, PMCID: PMC4941099, DOI: 10.1161/circulationaha.115.014281.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBody Mass IndexCardiovascular AgentsComorbidityContraindicationsCross-Sectional StudiesDrug HypersensitivityDrug PrescriptionsDrug SubstitutionDrug Therapy, CombinationDrug UtilizationEvidence-Based MedicineFemaleGuideline AdherenceHeart FailureHospitalsHumansMaleMedication AdherenceMiddle AgedPatient AdmissionPatient DischargePolypharmacyPractice Guidelines as TopicQuality Assurance, Health CareConceptsHF quality measuresHydralazine/isosorbide dinitrateAngiotensin receptor blockersMedication groupHeart failureAldosterone antagonistsReceptor blockersMedication regimenIsosorbide dinitrateNew medicationsΒ-blockersEnzyme inhibitorsGuideline-directed medical therapyInitiation of angiotensinPrimary discharge diagnosisQuarter of patientsPatient's medication regimenHospital quality measuresAdequate prescribingMedication initiationHospital dischargeHospital admissionMedical therapyGuideline recommendationsDischarge diagnosisTrajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study
Dharmarajan K, Hsieh AF, Kulkarni VT, Lin Z, Ross JS, Horwitz LI, Kim N, Suter LG, Lin H, Normand SL, Krumholz HM. Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. The BMJ 2015, 350: h411. PMID: 25656852, PMCID: PMC4353309, DOI: 10.1136/bmj.h411.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyHeart failureRisk of deathMyocardial infarctionFirst readmissionAbsolute riskOlder patientsCohort studyRelative riskMedicare feeService beneficiariesRisk of readmissionGeneral elderly populationGeneral older populationRisk trajectoriesHigh-risk periodHospital dischargeHospital admissionDischarge diagnosisAdverse outcomesReadmissionHospitalizationTrajectories of riskElderly population
2014
Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010
Gupta A, Wang Y, Spertus JA, Geda M, Lorenze N, Nkonde-Price C, D'Onofrio G, Lichtman JH, Krumholz HM. Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010. Journal Of The American College Of Cardiology 2014, 64: 337-345. PMID: 25060366, PMCID: PMC4415523, DOI: 10.1016/j.jacc.2014.04.054.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionLength of stayHospital mortalityHospitalization ratesClinical characteristicsAge groupsAMI hospitalization ratesYounger patientsMyocardial infarctionLonger LOSNationwide Inpatient Sample dataYoung womenU.S. hospital dischargesPrevalence of comorbiditiesPrincipal discharge diagnosisNational Inpatient SampleSex differencesContemporary longitudinal dataLarge national datasetMore comorbiditiesHospital dischargeDischarge diagnosisInpatient SampleMortality rateAge 30
2013
Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Suter LG, Bernheim SM, Drye EE, Krumholz HM. Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions. The BMJ 2013, 347: f6571. PMID: 24259033, PMCID: PMC3898430, DOI: 10.1136/bmj.f6571.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyReadmission diagnosesReadmission ratesHeart failureMyocardial infarctionCohort studySpecific diagnosisReadmission performanceHospital readmission performancePatterns of readmissionDay readmission rateRisk-standardized readmission ratesLow performing hospitalsHospital performanceHigh performing hospitalsReadmission timingDay readmissionHospital stayIndex admissionHospital dischargeReadmission patternsHospital admissionCommon diagnosisMedian timeLong-Term Outcomes in Elderly Survivors of In-Hospital Cardiac Arrest
Chan PS, Nallamothu BK, Krumholz HM, Spertus JA, Li Y, Hammill BG, Curtis LH. Long-Term Outcomes in Elderly Survivors of In-Hospital Cardiac Arrest. New England Journal Of Medicine 2013, 368: 1019-1026. PMID: 23484828, PMCID: PMC3652256, DOI: 10.1056/nejmoa1200657.Peer-Reviewed Original ResearchConceptsHospital cardiac arrestCardiac arrestNeurologic disabilityReadmission ratesElderly survivorsRisk-adjusted ratesNeurologic statusHeart failureIn-Hospital Cardiac ArrestInpatient cardiac arrestsSevere neurologic disabilityDemographic characteristicsLong-term outcomesLong-term survivalYears of ageRate of survivalHospital dischargeOlder patientsYounger patientsWhite patientsBlack patientsTerm outcomesNational registryMedicare filesPatients