2014
Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission.
Horwitz LI, Partovian C, Lin Z, Grady JN, Herrin J, Conover M, Montague J, Dillaway C, Bartczak K, Suter LG, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission. Annals Of Internal Medicine 2014, 161: s66-75. PMID: 25402406, PMCID: PMC4235629, DOI: 10.7326/m13-3000.Peer-Reviewed Original ResearchConceptsUnplanned readmissionReadmission measuresReadmission ratesReadmission riskMedicare feeHospital-wide readmission measureRisk-standardized readmission ratesPayer dataAdministrative Claims MeasureRisk-standardized ratesAverage-risk patientsUnplanned readmission rateDays of dischargeHospital risk-standardized readmission ratesAdult hospitalizationsComorbid conditionsPrincipal diagnosisClaims dataService claimsService beneficiariesReadmissionMeasure development studiesMedicaid ServicesRisk adjustmentHospitalRisk Adjustment of Ischemic Stroke Outcomes for Comparing Hospital Performance
Katzan IL, Spertus J, Bettger JP, Bravata DM, Reeves MJ, Smith EE, Bushnell C, Higashida RT, Hinchey JA, Holloway RG, Howard G, King RB, Krumholz HM, Lutz BJ, Yeh RW. Risk Adjustment of Ischemic Stroke Outcomes for Comparing Hospital Performance. Stroke 2014, 45: 918-944. PMID: 24457296, DOI: 10.1161/01.str.0000441948.35804.77.Peer-Reviewed Original ResearchMeSH KeywordsAmerican Heart AssociationBrain IschemiaHospitalsHumansModels, OrganizationalOutcome Assessment, Health CarePatient ReadmissionPredictive Value of TestsPrognosisQuality of Health CareRecovery of FunctionReproducibility of ResultsRisk AdjustmentSample SizeStrokeTreatment OutcomeUnited StatesConceptsIschemic stroke outcomeRisk-adjustment modelsStroke severityStroke outcomeStroke careOutcome measuresHospital levelRisk-adjusted outcome comparisonsRisk adjustmentHospital-level outcomesHospital performanceVascular risk factorsImportant prognostic factorIschemic stroke careIndividual patient levelStroke severity measuresRisk-adjusted modelsHospital-level performanceQuality of strokeComparison of qualityIschemic strokePrognostic factorsComorbid conditionsFunctional outcomeMajor disability
2006
Risks Associated With Statin Therapy
Kashani A, Phillips CO, Foody JM, Wang Y, Mangalmurti S, Ko DT, Krumholz HM. Risks Associated With Statin Therapy. Circulation 2006, 114: 2788-2797. PMID: 17159064, DOI: 10.1161/circulationaha.106.624890.Peer-Reviewed Original ResearchConceptsCreatine kinase elevationStatin therapyTransaminase elevationClinical trialsStatin trialsAdverse eventsHigher statin dosesMajor statin trialsRandomized statin trialsReports of myalgiaRisk of myalgiaWithdrawal of therapySevere comorbid conditionsSmall excess riskSignificant absolute increaseEnglish-language reportsHepatic complicationsStatin monotherapyCardiovascular eventsStatin dosesMost patientsComorbid conditionsAbsolute riskExcess riskElectronic search
2005
Anemia and Outcomes in Patients With Heart Failure: A Study From the National Heart Care Project
Kosiborod M, Curtis JP, Wang Y, Smith GL, Masoudi FA, Foody JM, Havranek EP, Krumholz HM. Anemia and Outcomes in Patients With Heart Failure: A Study From the National Heart Care Project. JAMA Internal Medicine 2005, 165: 2237-2244. PMID: 16246989, DOI: 10.1001/archinte.165.19.2237.Peer-Reviewed Original ResearchConceptsHeart failureLower hematocrit levelsIndependent predictorsHematocrit levelsComorbid illnessesHigh riskCare ProjectMultivariable logistic regression analysisPatients 65 yearsPrincipal discharge diagnosisAcute care hospitalsLogistic regression analysisLow hematocrit valuesCause mortalityHF patientsMultiple comorbiditiesMultivariable adjustmentOlder patientsCare hospitalClinical factorsHospital readmissionComorbid conditionsDischarge diagnosisSevere anemiaAdverse outcomesTimes to Treatment in Transfer Patients Undergoing Primary Percutaneous Coronary Intervention in the United States
Nallamothu BK, Bates ER, Herrin J, Wang Y, Bradley EH, Krumholz HM. Times to Treatment in Transfer Patients Undergoing Primary Percutaneous Coronary Intervention in the United States. Circulation 2005, 111: 761-767. PMID: 15699253, DOI: 10.1161/01.cir.0000155258.44268.f8.Peer-Reviewed Original ResearchConceptsPrimary PCIPrimary percutaneous coronary interventionST-segment elevation myocardial infarctionPercutaneous coronary interventionBalloon timeTransfer patientsCoronary interventionInterhospital transferMyocardial infarctionTotal doorRecent clinical trialsSpecific ECG findingsMultivariable hierarchical modelsChest painHospital presentationInitial hospitalFibrinolytic therapyPCI hospitalsPrimary outcomeSymptom onsetComorbid conditionsTreatment delayECG findingsHospital characteristicsNational registry
2004
Delay in diagnosis of acute myocardial infarction: Increasingly common, lower quality of care
Graff L, Wang Y, Foody J, Meehan T, Tuozzo K, Krumholz H, Radford M. Delay in diagnosis of acute myocardial infarction: Increasingly common, lower quality of care. Annals Of Emergency Medicine 2004, 44: s46. DOI: 10.1016/j.annemergmed.2004.07.151.Peer-Reviewed Original ResearchAcute myocardial infarctionQuality of careDiagnosis of AMIUnstable anginaMyocardial infarctionAMI casesPossible acute myocardial infarctionCoronary artery diseaseMedical record abstractionPrincipal discharge diagnosisSecondary diagnosis codesAMI dischargeDischarge therapyAdmission diagnosisComorbidity scoreArtery diseasePatient characteristicsComorbid conditionsRecord abstractionAcute careDischarge diagnosisDiagnosis codesAnginaAMI diagnosisCare measurement
2003
Effects of age on the quality of care provided to older patients with acute myocardial infarction
Rathore SS, Mehta RH, Wang Y, Radford MJ, Krumholz HM. Effects of age on the quality of care provided to older patients with acute myocardial infarction. The American Journal Of Medicine 2003, 114: 307-315. PMID: 12681459, DOI: 10.1016/s0002-9343(02)01531-0.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAge FactorsAgedAged, 80 and overAttitude of Health PersonnelCohort StudiesCombined Modality TherapyCoronary Care UnitsCritical CareDrug UtilizationFemaleGuideline AdherenceHealth Services AccessibilityHealth Services for the AgedHumansLogistic ModelsMaleMedicareMyocardial InfarctionOdds RatioPractice Patterns, Physicians'Quality of Health CareRisk AssessmentSurvival AnalysisThrombolytic TherapyUnited StatesConceptsAcute reperfusion therapyAcute myocardial infarctionMyocardial infarctionReperfusion therapyEffect of ageElderly patientsOlder patientsAge-associated variationsGuideline-recommended medical therapyAngiotensin-converting enzyme inhibitorGuideline-indicated therapiesPrescription of aspirinUse of aspirinCooperative Cardiovascular ProjectUse of therapiesQuality of careAcute reperfusionTreatment contraindicationsMedical therapyComorbid conditionsACE inhibitorsMedicare patientsHospital effectsPatientsEnzyme inhibitors
2002
Cardiac outcomes after myocardial infarction in elderly patients with diabetes mellitus.
Chyun D, Vaccarino V, Murillo J, Young LH, Krumholz HM. Cardiac outcomes after myocardial infarction in elderly patients with diabetes mellitus. American Journal Of Critical Care 2002, 11: 504-19. PMID: 12425401, DOI: 10.4037/ajcc2002.11.6.504.Peer-Reviewed Original ResearchConceptsRecurrent myocardial infarctionInsulin-treated diabetes mellitusDiabetes mellitusMyocardial infarctionElderly patientsHeart failureVentricular functionComorbid conditionsClinical findingsIndex myocardial infarctionPoor ventricular functionInsulin-treated diabetesAcute myocardial infarctionCardiac outcomesPoor outcomeMedical recordsMellitusInfarctionMedicare beneficiariesPatientsGreater riskInsulinMortalityRiskOutcomesAcute myocardial infarction in the elderly with diabetes
Chyun D, Vaccarino V, Murillo J, Young LH, Krumholz HM. Acute myocardial infarction in the elderly with diabetes. Heart & Lung 2002, 31: 327-339. PMID: 12487011, DOI: 10.1067/mhl.2002.126049.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionDiabetes mellitusMyocardial infarctionHeart failureComorbid conditionsMortality rateNon-Q-wave myocardial infarctionHistory of DMInsulin-treated diabetes mellitusRetrospective medical record reviewHigher body mass indexAcute MI settingPoor functional statusBlood pressure managementMedical record reviewSpecific comorbid conditionsSecondary preventive interventionsBody mass indexShort-term mortalityCooperative Cardiovascular ProjectEntire Medicare populationShort-term riskAggressive lipidDM statusChest pain
2000
Care and outcomes of elderly patients with acute myocardial infarction by physician specialty: the effects of comorbidity and functional limitations
Chen J, Radford M, Wang Y, Krumholz H. Care and outcomes of elderly patients with acute myocardial infarction by physician specialty: the effects of comorbidity and functional limitations. The American Journal Of Medicine 2000, 108: 460-469. PMID: 10781778, DOI: 10.1016/s0002-9343(00)00331-4.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedCardiologyComorbidityFamily PracticeFemaleGeriatric AssessmentHospital MortalityHospitalizationHumansInternal MedicineMaleMedicareMyocardial InfarctionPractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRetrospective StudiesSeverity of Illness IndexSurvival AnalysisTreatment OutcomeUnited StatesConceptsAcute myocardial infarctionMyocardial infarctionGeneral practitionersPhysician specialtyFunctional limitationsComorbid illnessesPatient characteristicsSurvival benefitComorbid conditionsCardiology careNational Cooperative Cardiovascular ProjectEffect of comorbidityCooperative Cardiovascular ProjectBoard-certified cardiologistsInternal medicine subspecialistsMost comorbiditiesClinical characteristicsElderly patientsClinical presentationSpecialty careHospital characteristicsExcess mortalityBaseline differencesMedicine subspecialistsGeneral internists
1998
Sex Differences in Mortality After Myocardial Infarction: Evidence for a Sex-Age Interaction
Vaccarino V, Horwitz RI, Meehan TP, Petrillo MK, Radford MJ, Krumholz HM. Sex Differences in Mortality After Myocardial Infarction: Evidence for a Sex-Age Interaction. JAMA Internal Medicine 1998, 158: 2054-2062. PMID: 9778206, DOI: 10.1001/archinte.158.18.2054.Peer-Reviewed Original ResearchConceptsMyocardial infarctionMortality rateAge groupsSex-age interactionOlder womenHigh mortalityHigher hospital mortality rateSex differencesAge group 75 yearsHospital mortality rateRetrospective cohort studyProcess of careYounger age groupsSame age groupHospital deathOlder patientsCohort studyConsecutive patientsPatient ageComorbid conditionsHospital characteristicsClinical severityMedical recordsConnecticut hospitalsHigher odds