2021
Impact of ST‐Segment–Elevation Myocardial Infarction Regionalization Programs on the Treatment and Outcomes of Patients Diagnosed With Non–ST‐Segment–Elevation Myocardial Infarction
Montoy JCC, Shen Y, Brindis RG, Krumholz HM, Hsia RY. Impact of ST‐Segment–Elevation Myocardial Infarction Regionalization Programs on the Treatment and Outcomes of Patients Diagnosed With Non–ST‐Segment–Elevation Myocardial Infarction. Journal Of The American Heart Association 2021, 10: e016932. PMID: 33470136, PMCID: PMC7955417, DOI: 10.1161/jaha.120.016932.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCaliforniaCoronary AngiographyEarly DiagnosisElectrocardiographyFemaleFollow-Up StudiesHospitalizationHumansMaleMiddle AgedNon-ST Elevated Myocardial InfarctionPercutaneous Coronary InterventionPrognosisProgram EvaluationRegistriesRetrospective StudiesRisk FactorsST Elevation Myocardial InfarctionSurvival RateTreatment OutcomeConceptsOutcomes of patientsEarly angiographyMyocardial infarctionST segmentST-segment elevation myocardial infarctionSegment elevation myocardial infarctionProportion of patientsElevation myocardial infarctionRisk of deathRisk of mortalityRegionalization programIndex admissionEmergency departmentRegionalized careNonfederal hospitalsMAIN OUTCOMETimely carePatientsAngiographyOverall populationNSTEMIInfarctionStudy periodMortalityCare
2020
Association Between Subsequent Hospitalizations and Recurrent Acute Myocardial Infarction Within 1 Year After Acute Myocardial Infarction
Wang Y, Leifheit E, Normand S, Krumholz HM. Association Between Subsequent Hospitalizations and Recurrent Acute Myocardial Infarction Within 1 Year After Acute Myocardial Infarction. Journal Of The American Heart Association 2020, 9: e014907. PMID: 32172654, PMCID: PMC7335517, DOI: 10.1161/jaha.119.014907.Peer-Reviewed Original ResearchConceptsRecurrent acute myocardial infarctionAcute myocardial infarctionIndex acute myocardial infarctionClinical Classification SoftwareMyocardial infarctionDisease categoriesRisk of deathCox regression modelPost-acute careAcute care hospitalsOccurrence of hospitalizationLow recurrence riskUnplanned rehospitalizationSubsequent hospitalizationBackground PatientsHazard ratioPatient characteristicsSecondary preventionMedian timeService patientsChronic diseasesPatient riskOutcome measuresRehospitalizationHigh riskPost-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States
Khera R, Wang Y, Bernheim SM, Lin Z, Krumholz HM. Post-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States. The BMJ 2020, 368: l6831. PMID: 31941686, PMCID: PMC7190056, DOI: 10.1136/bmj.l6831.Peer-Reviewed Original ResearchConceptsAcute care utilizationAcute myocardial infarctionRetrospective cohort studyHeart failureCare utilizationPost-discharge periodEmergency departmentMyocardial infarctionDay mortalityCohort studyHospital admissionObservation unitAcute careNational retrospective cohort studyPost-acute care utilizationHospital Readmissions Reduction ProgramObservation unit carePost-discharge mortalityDay readmission rateRisk of deathReadmissions Reduction ProgramReadmission reduction initiativesReadmission ratesUnit careInpatient unit
2019
Machine Learning Prediction of Mortality and Hospitalization in Heart Failure With Preserved Ejection Fraction
Angraal S, Mortazavi BJ, Gupta A, Khera R, Ahmad T, Desai NR, Jacoby DL, Masoudi FA, Spertus JA, Krumholz HM. Machine Learning Prediction of Mortality and Hospitalization in Heart Failure With Preserved Ejection Fraction. JACC Heart Failure 2019, 8: 12-21. PMID: 31606361, DOI: 10.1016/j.jchf.2019.06.013.Peer-Reviewed Original ResearchConceptsHF hospitalizationRisk of mortalityEjection fractionBlood urea nitrogen levelsLogistic regressionPrevious HF hospitalizationHeart failure hospitalizationReduced ejection fractionReceiver-operating characteristic curveRisk of deathBody mass indexBlood urea nitrogenUrea nitrogen levelsHealth status dataMean c-statisticKCCQ scoresTOPCAT trialFailure hospitalizationHeart failureHemoglobin levelsMass indexC-statisticHospitalizationUrea nitrogenMortality
2017
Risk Trajectories of Readmission and Death in the First Year after Hospitalization for Chronic Obstructive Pulmonary Disease
Lindenauer PK, Dharmarajan K, Qin L, Lin Z, Gershon AS, Krumholz HM. Risk Trajectories of Readmission and Death in the First Year after Hospitalization for Chronic Obstructive Pulmonary Disease. American Journal Of Respiratory And Critical Care Medicine 2017, 197: 1009-1017. PMID: 29206052, PMCID: PMC5909167, DOI: 10.1164/rccm.201709-1852oc.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseSame respective groupsObstructive pulmonary diseaseVentilator supportPulmonary diseaseRisk of readmissionRisk of hospitalizationGeneral elderly populationGeneral Medicare populationRisk of deathDaily riskRespective groupsReadmission ratesHospital readmissionAbsolute riskMedicare populationReadmissionElderly populationMedicare beneficiariesHospitalizationClinical servicesFirst monthProlonged riskDeathLongitudinal outcomes
2016
Trajectories 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
Trajectories 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
2013
Regional Density of Cardiologists and Rates of Mortality for Acute Myocardial Infarction and Heart Failure
Kulkarni VT, Ross JS, Wang Y, Nallamothu BK, Spertus JA, Normand SL, Masoudi FA, Krumholz HM. Regional Density of Cardiologists and Rates of Mortality for Acute Myocardial Infarction and Heart Failure. Circulation Cardiovascular Quality And Outcomes 2013, 6: 352-359. PMID: 23680965, PMCID: PMC5323047, DOI: 10.1161/circoutcomes.113.000214.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiologyCohort StudiesFemaleHealth Services AccessibilityHealth Services Needs and DemandHealthcare DisparitiesHeart FailureHospitalizationHumansLinear ModelsLogistic ModelsMaleMedicareMyocardial InfarctionOdds RatioPhysiciansPneumoniaPrognosisResidence CharacteristicsRisk AssessmentRisk FactorsTime FactorsUnited StatesWorkforceConceptsAcute myocardial infarctionHeart failureHospital referral regionsMortality riskLowest quintileMyocardial infarctionReferral regionsMedicare administrative claims dataCharacteristics of patientsRisk of deathAdministrative claims dataHierarchical logistic regression modelsLogistic regression modelsRate of mortalityRegional densityHighest quintileNumber of cardiologistsWorse outcomesClaims dataPatientsPneumoniaCardiologistsHospitalizationAdmissionQuintileIncome inequality and 30 day outcomes after acute myocardial infarction, heart failure, and pneumonia: retrospective cohort study
Lindenauer PK, Lagu T, Rothberg MB, Avrunin J, Pekow PS, Wang Y, Krumholz HM. Income inequality and 30 day outcomes after acute myocardial infarction, heart failure, and pneumonia: retrospective cohort study. The BMJ 2013, 346: f521. PMID: 23412830, PMCID: PMC3573180, DOI: 10.1136/bmj.f521.Peer-Reviewed Original ResearchConceptsIncome inequalityAcute myocardial infarctionUS statesRetrospective cohort studyDay of admissionHeart failureMyocardial infarctionCohort studyInequality levelsIndividual incomeGini coefficientUS acute care hospitalsHighest quarterDays of dischargeDays of hospitalizationRisk of readmissionRisk of deathPatient socioeconomic characteristicsRisk of mortalityAcute care hospitalsSocioeconomic characteristicsInequalityLogistic regression modelsCare hospitalReadmission analysis
2007
The Impact of Venous Thromboembolism on Risk of Death or Hemorrhage in Older Cancer Patients
Gross CP, Galusha DH, Krumholz HM. The Impact of Venous Thromboembolism on Risk of Death or Hemorrhage in Older Cancer Patients. Journal Of General Internal Medicine 2007, 22: 321-326. PMID: 17356962, PMCID: PMC1824718, DOI: 10.1007/s11606-006-0019-x.Peer-Reviewed Original ResearchConceptsRisk of deathOlder cancer patientsConcomitant venous thromboembolismVenous thromboembolismMajor hemorrhageCancer patientsCancer typesCancer diagnosisMedicare administrative claims dataPrevalence of VTEEnd Results cancer registryRetrospective cohort studyAdministrative claims dataCohort studyCancer RegistryInvasive cancerExcess riskMost cancer typesCancer stageClaims dataHemorrhagePatientsSociodemographic factorsPotential mediatorsDeath
2006
Acute, Severe Noncardiac Conditions in Patients with Acute Myocardial Infarction
Lichtman JH, Fathi A, Radford MJ, Lin Z, Loeser CS, Krumholz HM. Acute, Severe Noncardiac Conditions in Patients with Acute Myocardial Infarction. The American Journal Of Medicine 2006, 119: 843-850. PMID: 17000215, DOI: 10.1016/j.amjmed.2006.03.040.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoncardiac conditionsHospital mortalityPrognostic importanceMyocardial infarctionMortality riskYale-New Haven HospitalExcessive mortality riskHospital mortality riskSubgroup of patientsSubset of patientsRisk-adjusted analysisRisk of deathMultivariable logistic modelCardiac severityInitial therapyConsecutive patientsClinical presentationMultivariable analysisMedical historyPatientsPatient recordsMortalityMarked increaseInfarction
2004
The association of 6-minute walk performance and outcomes in stable outpatients with heart failure.
Curtis JP, Rathore SS, Wang Y, Krumholz HM. The association of 6-minute walk performance and outcomes in stable outpatients with heart failure. Journal Of Cardiac Failure 2004, 10: 9-14. PMID: 14966769, DOI: 10.1016/s1071-9164(03)00705-x.Peer-Reviewed Original ResearchThe association of 6-minute walk performance and outcomes in stable outpatients with heart failure
Curtis J, Rathore S, Wang Y, Krumholz H. The association of 6-minute walk performance and outcomes in stable outpatients with heart failure. Journal Of Cardiac Failure 2004, 10: 9-14. DOI: 10.1016/j.cardfail.2003.08.010.Peer-Reviewed Original ResearchHeart failureWalk testStable outpatientsDigitalis Investigation Group trialRisk of deathCause mortalityIdentifies patientsMultivariable analysisPrognostic valuePrognostic informationGroup trialsWalk performancePatientsTest distanceMortalityDeathOutpatientsOutcomesFailureAssociationBackgroundWeTrialsMonths
2003
Worsening renal function: What is a clinically meaningful change in creatinine during hospitalization with heart failure?
Smith GL, Vaccarino V, Kosiborod M, Lichtman JH, Cheng S, Watnick SG, Krumholz HM. Worsening renal function: What is a clinically meaningful change in creatinine during hospitalization with heart failure? Journal Of Cardiac Failure 2003, 9: 13-25. PMID: 12612868, DOI: 10.1054/jcaf.2003.3.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersCohort StudiesConnecticutCreatinineFemaleFollow-Up StudiesHeart FailureHospitalizationHumansKidney DiseasesKidney Function TestsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsProspective StudiesRisk FactorsSensitivity and SpecificityStatistics as TopicStroke VolumeSurvival AnalysisConceptsCreatinine elevationRenal functionHeart failureAdverse outcomesRisk of deathNumber of patientsMagnitude of riskBaseline creatinineProspective cohortRisk factorsFunctional declineHigh riskPatientsCreatinineMortalityHospitalizationDeathDlImportant predictorRiskElevationMeaningful changeMaximum specificityOutcomesBetter definitionThe prognostic importance of anemia in patients with heart failure
Kosiborod M, Smith GL, Radford MJ, Foody JM, Krumholz HM. The prognostic importance of anemia in patients with heart failure. The American Journal Of Medicine 2003, 114: 112-119. PMID: 12586230, DOI: 10.1016/s0002-9343(02)01498-5.Peer-Reviewed Original ResearchConceptsHeart failureLow hematocritHospital readmissionPrognostic importanceHematocrit levelsMultivariate Cox proportional hazards regressionLeft ventricular ejection fractionCox proportional hazards regressionTraditional risk factorsVentricular ejection fractionPrincipal discharge diagnosisProportional hazards regressionRisk of deathElderly patientsOlder patientsClinical factorsEjection fractionIndependent predictorsDischarge diagnosisHazards regressionMedian hematocritPrognostic valueMean ageTreatable conditionRisk factors
2002
Sex-Based Differences in the Effect of Digoxin for the Treatment of Heart Failure
Rathore SS, Wang Y, Krumholz HM. Sex-Based Differences in the Effect of Digoxin for the Treatment of Heart Failure. New England Journal Of Medicine 2002, 347: 1403-1411. PMID: 12409542, DOI: 10.1056/nejmoa021266.Peer-Reviewed Original ResearchConceptsEffect of digoxinDepressed left ventricular systolic functionLeft ventricular systolic functionVentricular systolic functionSex-based differencesRate of deathDigoxin therapyHeart failureSystolic functionMultivariable Cox proportional hazards modelsDigitalis Investigation Group (DIG) studyDigitalis Investigation Group trialCox proportional hazards modelHeart failure variesPrimary end pointRisk of deathProportional hazards modelMantel-Haenszel testOverall mortalityTherapy differsEpidemiologic featuresMultivariable analysisClinical variablesSubgroup analysisGroup trialsMortality associated with the quality of care of patients hospitalized with congestive heart failure
Luthi J, Mcclellan WM, Fitzgerald D, Krumholz HM, Delaney RJ, Bratzler DW, Elward K, Cangialose C, Ballard D. Mortality associated with the quality of care of patients hospitalized with congestive heart failure. International Journal For Quality In Health Care 2002, 14: 15-24. PMID: 11871625, DOI: 10.1093/intqhc/14.1.15.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsCohort StudiesGuideline AdherenceHeart FailureHospital MortalityHospitalizationHumansMedicareOutcome and Process Assessment, Health CarePatient DischargeProportional Hazards ModelsQuality of Health CareRetrospective StudiesRisk AssessmentSurvival AnalysisUnited StatesVentricular Dysfunction, LeftConceptsLeft ventricular systolic dysfunctionCongestive heart failureRisk of deathElderly patientsHazard ratioHeart failurePresence of LVSDAdjusted hazard ratioRetrospective cohort studyUse of angiotensinVentricular systolic dysfunctionClinical practice guidelinesQuality of careACEI doseACEI treatmentSystolic dysfunctionCohort studyDischarge medicationsEjection fractionVentricular functionMean agePractice guidelinesACEIMedicare beneficiariesPatients
1999
Sex-Based Differences in Early Mortality after Myocardial Infarction
Vaccarino V, Parsons L, Every N, Barron H, Krumholz H. Sex-Based Differences in Early Mortality after Myocardial Infarction. New England Journal Of Medicine 1999, 341: 217-225. PMID: 10413733, DOI: 10.1056/nejm199907223410401.Peer-Reviewed Original ResearchConceptsMyocardial infarctionYears of ageMortality rateSex-based differencesYoung womenMyocardial Infarction 2Odds of deathOverall mortality rateRisk of deathShort-term mortalityHigh-risk groupLogistic regression analysisHigh mortality ratePrognostic factorsEarly mortalityEarly managementMedical historyNational registryClinical severityHigh riskOlder womenInfarctionPatientsHospitalizationWomen
1992
Cost Effectiveness of Thrombolytic Therapy with Streptokinase in Elderly Patients with Suspected Acute Myocardial Infarction
Krumholz H, Pasternak R, Weinstein M, Friesinger G, Ridker P, Tosteson A, Goldman L. Cost Effectiveness of Thrombolytic Therapy with Streptokinase in Elderly Patients with Suspected Acute Myocardial Infarction. New England Journal Of Medicine 1992, 327: 7-13. PMID: 1598117, DOI: 10.1056/nejm199207023270102.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionThrombolytic therapyRisk of deathMyocardial infarctionElderly patientsPatients 75 yearsST-segment elevationOnset of symptomsUse of streptokinaseOne-way sensitivity analysesDecision analytic modelYears of lifeCost-effective treatmentRelative reductionHospital deathStreptokinase therapyOlder patientsClinical circumstancesThrombolytic agentsInfarctionPatientsCost effectivenessTherapyLack of consensusStreptokinase