2020
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
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 ResearchSex Differences in Symptom Phenotypes Among Patients With Acute Myocardial Infarction
Brush JE, Krumholz HM, Greene EJ, Dreyer RP. Sex Differences in Symptom Phenotypes Among Patients With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2020, 13: e005948. PMID: 32063049, PMCID: PMC7041412, DOI: 10.1161/circoutcomes.119.005948.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBiological Variation, IndividualFemaleHealth Status DisparitiesHumansInterviews as TopicMaleMiddle AgedMyocardial InfarctionPatient AdmissionPhenotypePredictive Value of TestsProspective StudiesRisk AssessmentRisk FactorsSex FactorsSpainSymptom AssessmentUnited StatesYoung AdultConceptsAcute myocardial infarctionMyocardial infarctionMedical recordsYoung womenDiagnosis of AMIObservational cohort studyMedical record abstractionSymptom phenotypeDiagnostic processAnalysis of symptomsVIRGO StudyCohort studyRecord abstractionIndividual patientsClinician's abilityDiagnosis rateStandardized interviewPhenotype subgroupsSymptomsSimilar findingsYoung adultsWomenMenInfarctionPatients
2019
Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction
Nanna MG, Hajduk AM, Krumholz HM, Murphy TE, Dreyer RP, Alexander KP, Geda M, Tsang S, Welty FK, Safdar B, Lakshminarayan DK, Chaudhry SI, Dodson JA. Sex-Based Differences in Presentation, Treatment, and Complications Among Older Adults Hospitalized for Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005691. PMID: 31607145, PMCID: PMC6913190, DOI: 10.1161/circoutcomes.119.005691.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overComorbidityDisability EvaluationFemaleHealth Status DisparitiesHealthcare DisparitiesHumansLife StyleMaleMyocardial RevascularizationNon-ST Elevated Myocardial InfarctionPatient AdmissionPrevalenceProspective StudiesRisk AssessmentRisk FactorsSex FactorsSocial Determinants of HealthST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionSex-based differencesPercutaneous coronary interventionFunctional impairmentOlder adultsHospital complicationsCoronary interventionOlder patientsCoronary diseaseMyocardial infarctionAge-related functional impairmentsAge-associated functional impairmentsLower ratesPrior coronary diseaseObstructive coronary diseaseProspective observational studyNSTEMI subgroupSTEMI subgroupUnderwent revascularizationAcute myocardialChest painClinical presentationAMI subgroupRisk factorsHigh prevalenceThirty-Day Hospital Readmission After Acute Myocardial Infarction in China
Li J, Dharmarajan K, Bai X, Masoudi FA, Spertus JA, Li X, Zheng X, Zhang H, Yan X, Dreyer RP, Krumholz HM, Group F. Thirty-Day Hospital Readmission After Acute Myocardial Infarction in China. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005628. PMID: 31092023, DOI: 10.1161/circoutcomes.119.005628.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionUnplanned cardiovascular readmissionsDays of dischargeMyocardial infarctionCardiovascular readmissionCause readmissionMost readmissionsLower riskFit Cox proportional hazards modelsST-segment elevation myocardial infarctionAcute Coronary Events (GRACE) scoreThirty-day hospital readmissionsDisease-specific health statusCox proportional hazards modelVentricular ejection fractionProportional hazards modelLow social supportBackground ReadmissionRecurrent anginaCardiovascular eventsHospital complicationsUnplanned readmissionIndex hospitalizationClinical factorsConsecutive patientsThirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Goldstein D, Forman DE, Alexander KP, Gill TM, Chaudhry SI. Thirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005320. PMID: 31010300, PMCID: PMC6481309, DOI: 10.1161/circoutcomes.118.005320.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overFemaleGeriatric AssessmentHealth Status IndicatorsHumansMaleMyocardial InfarctionPatient AdmissionPatient ReadmissionPredictive Value of TestsProspective StudiesReproducibility of ResultsRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionReadmission risk modelFinal risk modelFunctional mobilityFunctional impairmentMyocardial infarctionOlder adultsFirst diastolic blood pressureChronic obstructive pulmonary diseaseAge-related functional impairmentsP2Y12 inhibitor useAcute kidney injuryDaily living (ADL) disabilityPatient-level factorsProspective cohort studyDiastolic blood pressureObstructive pulmonary diseasePatients of ageGeneral health statusStrongest predictorRisk modelMore comorbiditiesCause readmissionKidney injuryCohort study
2018
Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction
Graham GN, Jones PG, Chan PS, Arnold SV, Krumholz HM, Spertus JA. Racial Disparities in Patient Characteristics and Survival After Acute Myocardial Infarction. JAMA Network Open 2018, 1: e184240. PMID: 30646346, PMCID: PMC6324589, DOI: 10.1001/jamanetworkopen.2018.4240.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionWhite patientsBlack patientsMortality rate differencesMortality ratePatient characteristicsMyocardial infarctionPropensity scoreAcute Myocardial Infarction Patients' Health Status (TRIUMPH) registrySelf-identified black patientsObserved survival differencesNational Death IndexTime of admissionLower propensity scoreProspective registryClinical characteristicsCohort studyDeath IndexHighest quintileBlack raceC-statisticSurvival differencesWorse outcomesMAIN OUTCOMEPatientsAdmission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates
Benchetrit L, Zimmerman C, Bao H, Dharmarajan K, Altaf F, Herrin J, Lin Z, Krumholz HM, Drye EE, Lipska KJ, Spatz ES. Admission diagnoses among patients with heart failure: Variation by ACO performance on a measure of risk-standardized acute admission rates. American Heart Journal 2018, 207: 19-26. PMID: 30404047, DOI: 10.1016/j.ahj.2018.09.006.Peer-Reviewed Original ResearchMeSH KeywordsAccountable Care OrganizationsAgedAlgorithmsAnalysis of VarianceCardiovascular DiseasesComorbidityFemaleHeart FailureHospitalizationHumansInternational Classification of DiseasesMaleMedicare Part AMedicare Part BPatient AdmissionPatient DischargePatient-Centered CareSex DistributionTime FactorsUnited StatesConceptsHeart failureAccountable care organizationsMean admission rateAdmission ratesAdmission typeAcute admission ratesNoncardiovascular conditionsAdmission diagnosisCause admission ratesMedicare Shared Savings Program Accountable Care OrganizationsRate of hospitalizationPrincipal discharge diagnosisProportion of admissionsType of admissionNoncardiovascular causesHF admissionsHF patientsPerson yearsDischarge diagnosisPatient populationPatientsAdmissionKey quality metricDiagnosisSubstantial proportionClinical 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
2016
Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time
Dharmarajan K, Qin L, Lin Z, Horwitz LI, Ross JS, Drye EE, Keshawarz A, Altaf F, Normand SL, Krumholz HM, Bernheim SM. Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time. Health Affairs 2016, 35: 1294-1302. PMID: 27385247, DOI: 10.1377/hlthaff.2015.1614.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCenters for Medicare and Medicaid Services, U.S.Chronic DiseaseDatabases, FactualDisease ProgressionFemaleGeriatric AssessmentHospital MortalityHumansIncidenceLength of StayMaleOutcome Assessment, Health CarePatient AdmissionPatient ReadmissionRetrospective StudiesRisk AssessmentSeverity of Illness IndexTime FactorsUnited StatesRisk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations
Spatz ES, Lipska KJ, Dai Y, Bao H, Lin Z, Parzynski CS, Altaf FK, Joyce EK, Montague JA, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations. Medical Care 2016, 54: 528-537. PMID: 26918404, PMCID: PMC5356461, DOI: 10.1097/mlr.0000000000000518.Peer-Reviewed Original ResearchConceptsHeart failure measuresAccountable care organizationsAcute admission ratesHeart failureAdmission ratesNational ratesUnplanned hospital admissionsHeart failure cohortRisk-adjustment variablesPopulation-based measuresCare organizationsOutcome measure developmentIntraclass correlation coefficientHospital admissionDiabetes measuresFailure cohortChronic conditionsMedicare feeDiabetesService beneficiariesPatientsMeet criteriaMeasures of qualitySocioeconomic statusPerformance categoriesFibrinolytic therapy in hospitals without percutaneous coronary intervention capabilities in China from 2001 to 2011: China PEACE-retrospective AMI study
Li J, Li X, Ross JS, Wang Q, Wang Y, Desai NR, Xu X, Nuti SV, Masoudi FA, Spertus JA, Krumholz HM, Jiang L, Group F. Fibrinolytic therapy in hospitals without percutaneous coronary intervention capabilities in China from 2001 to 2011: China PEACE-retrospective AMI study. European Heart Journal Acute Cardiovascular Care 2016, 6: 232-243. PMID: 26787648, DOI: 10.1177/2048872615626656.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionFibrinolytic therapyMyocardial infarctionPercutaneous coronary intervention capabilitySequential cross-sectional studiesChina PEACE-Retrospective AMI StudyPrimary reperfusion strategyPercutaneous coronary interventionLittle clinical evidenceCross-sectional studyQuality of careTwo-stage random samplingCoronary interventionHospital delayNeedle timeReperfusion strategySymptom onsetTherapy useClinical evidenceEmergency departmentMedian admissionIdeal patientPatientsWeighted proportion
2015
Insurance and Prehospital Delay in Patients ≤55 Years With Acute Myocardial Infarction
Chen SI, Wang Y, Dreyer R, Strait KM, Spatz ES, Xu X, Smolderen KG, Desai NR, Lorenze NP, Lichtman JH, Spertus JA, D'Onofrio G, Bueno H, Masoudi FA, Krumholz HM. Insurance and Prehospital Delay in Patients ≤55 Years With Acute Myocardial Infarction. The American Journal Of Cardiology 2015, 116: 1827-1832. PMID: 26541907, PMCID: PMC5323057, DOI: 10.1016/j.amjcard.2015.09.018.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPrehospital delayInsurance statusMyocardial infarctionSpanish patientsGender differencesHealth care systemUS patientsProspective studyUS cohortUS womenPatientsUniversal insuranceCare systemWomenSignificant gender differencesInfarctionMenInsurance groupsHoursStatusAssociationLarge proportionDifferencesCohortRace, Socioeconomic Status, and Life Expectancy After Acute Myocardial Infarction
Bucholz EM, Ma S, Normand SL, Krumholz HM. Race, Socioeconomic Status, and Life Expectancy After Acute Myocardial Infarction. Circulation 2015, 132: 1338-1346. PMID: 26369354, PMCID: PMC5097251, DOI: 10.1161/circulationaha.115.017009.Peer-Reviewed Original ResearchHospital variation in admission to intensive care units for patients with acute myocardial infarction
Chen R, Strait KM, Dharmarajan K, Li SX, Ranasinghe I, Martin J, Fazel R, Masoudi FA, Cooke CR, Nallamothu BK, Krumholz HM. Hospital variation in admission to intensive care units for patients with acute myocardial infarction. American Heart Journal 2015, 170: 1161-1169. PMID: 26678638, PMCID: PMC5459386, DOI: 10.1016/j.ahj.2015.09.003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnterior Wall Myocardial InfarctionCoronary Care UnitsHealth Care RationingHospital MortalityHumansLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionQuality ImprovementRetrospective StudiesRisk AssessmentTriageUnited StatesConceptsAcute myocardial infarctionIntensive care unitCritical care therapiesRisk-standardized mortality ratesHospital risk-standardized mortality ratesICU admissionResource-intensive settingsCare therapyAMI patientsCare unitMyocardial infarctionMortality rateAdult hospitalizationsHospital variationNinth RevisionClinical ModificationICU triageInternational ClassificationBetter outcomesPatientsHospitalAdmissionPremier databaseTherapyAppropriate useMedication 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 diagnosisVariation in US Hospital Emergency Department Admission Rates by Clinical Condition
Venkatesh AK, Dai Y, Ross JS, Schuur JD, Capp R, Krumholz HM. Variation in US Hospital Emergency Department Admission Rates by Clinical Condition. Medical Care 2015, 53: 237-244. PMID: 25397965, PMCID: PMC4858175, DOI: 10.1097/mlr.0000000000000261.Peer-Reviewed Original ResearchConceptsEmergency Department Admission RatesED admission ratesAdmission ratesClinical conditionsMood disordersChronic obstructive pulmonary diseaseNational Emergency Department SampleAdult ED visitsNonspecific chest painObstructive pulmonary diseaseSoft tissue infectionsUrinary tract infectionEmergency Department SampleClinical Classification SoftwareCross-sectional analysisChest painED visitsTract infectionsPulmonary diseaseSpearman correlation coefficientTissue infectionsHospitalization ratesUS hospitalsCondition-specific variationsHospital correlationAssociation of Discharge Summary Quality With Readmission Risk for Patients Hospitalized With Heart Failure Exacerbation
Salim Al-Damluji M, Dzara K, Hodshon B, Punnanithinont N, Krumholz HM, Chaudhry SI, Horwitz LI. Association of Discharge Summary Quality With Readmission Risk for Patients Hospitalized With Heart Failure Exacerbation. Circulation Cardiovascular Quality And Outcomes 2015, 8: 109-111. PMID: 25587092, PMCID: PMC4303529, DOI: 10.1161/circoutcomes.114.001476.Peer-Reviewed Original Research
2014
ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data
Li J, Li X, Wang Q, Hu S, Wang Y, Masoudi FA, Spertus JA, Krumholz HM, Jiang L, Group F. ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data. The Lancet 2014, 385: 441-451. PMID: 24969506, PMCID: PMC4415374, DOI: 10.1016/s0140-6736(14)60921-1.Peer-Reviewed Original ResearchMeSH KeywordsAgedAspirinChinaClopidogrelFemaleFibrinolytic AgentsHealthcare DisparitiesHospital MortalityHospitals, RuralHospitals, UrbanHumansMaleMiddle AgedMyocardial InfarctionMyocardial ReperfusionPatient AdmissionPercutaneous Coronary InterventionQuality of Health CareRetrospective StudiesTiclopidineTreatment OutcomeConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionHospital mortalityHospital admissionMyocardial infarctionRetrospective analysisPrimary percutaneous coronary interventionAcute myocardial infarction admissionsProportion of patientsUse of aspirinPercutaneous coronary interventionMyocardial infarction admissionsTwo-stage random sampling designQuality of careAnalysis of treatmentBaseline characteristicsCardiac eventsHospital outcomesHospital stayCoronary interventionFamily Planning CommissionClinical profileHospital recordsMedian lengthSTEMI admissionsHospital variation in risk-standardized hospital admission rates from US EDs among adults
Capp R, Ross JS, Fox JP, Wang Y, Desai MM, Venkatesh AK, Krumholz HM. Hospital variation in risk-standardized hospital admission rates from US EDs among adults. The American Journal Of Emergency Medicine 2014, 32: 837-843. PMID: 24881514, DOI: 10.1016/j.ajem.2014.03.033.Peer-Reviewed Original ResearchConceptsHospital admission ratesEmergency departmentAdmission ratesClinical characteristicsED visitsHospital factorsClinical factorsAdult ED visitsUS emergency departmentsHospital teaching statusCross-sectional analysisPatient characteristicsHospital admissionHospital variationPatientsTeaching statusHospitalED dataVisitsRepresentative sampleAdultsRural locationsAdmissionFactorsNational variationsTransfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction
Barreto-Filho JA, Wang Y, Rathore SS, Spatz ES, Ross JS, Curtis JP, Nallamothu BK, Normand SL, Krumholz HM. Transfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction. JAMA Internal Medicine 2014, 174: 213-222. PMID: 24296747, DOI: 10.1001/jamainternmed.2013.11944.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCoronary artery bypass graft surgeryArtery bypass graft surgeryRisk-standardized mortality ratesBypass graft surgeryPercutaneous coronary interventionLength of stayMyocardial infarctionElderly patientsGraft surgeryRevascularization ratesCoronary interventionMortality rateLower risk-standardized mortality ratesRate of catheterizationHospital transfer ratesInvasive cardiac proceduresTransfer of patientsRisk-standardized mortalityHospital outcomesInitial admissionMedian lengthService patientsCardiac proceduresHospital differences