2019
Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data
Krumholz HM, Warner F, Coppi A, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Desai NR, Lin Z, Normand ST. Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data. JAMA Network Open 2019, 2: e198406. PMID: 31411709, PMCID: PMC6694388, DOI: 10.1001/jamanetworkopen.2019.8406.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failurePopulation-based programsPOA codesSingle diagnostic codeDiagnostic codesComparative effectiveness research studyPublic reportingIndex admission diagnosisDays of hospitalizationClinical Modification codesService claims dataAcute care hospitalsMultiple care settingsPatient-level modelsAdmission diagnosisTotal hospitalizationsCare hospitalPrevious diagnosisNinth RevisionMyocardial infarctionCandidate variablesCare settingsClaims dataMAIN OUTCOMEComparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data
Krumholz HM, Coppi AC, Warner F, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Lin Z, Normand ST. Comparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data. JAMA Network Open 2019, 2: e197314. PMID: 31314120, PMCID: PMC6647547, DOI: 10.1001/jamanetworkopen.2019.7314.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionICD-9-CM codesMortality risk modelHeart failureHospital admissionC-statisticMAIN OUTCOMEMortality rateRisk-standardized mortality ratesHospital risk-standardized mortality ratesIndex admission diagnosisPatients 65 yearsDays of hospitalizationComparative effectiveness studiesClaims-based dataHospital-level performance measuresMedicare claims dataPatient-level modelsCMS modelRisk-adjustment modelsRisk modelHospital performance measuresAdmission diagnosisNinth RevisionMyocardial infarction
2015
Intravenous Fluids in Acute Decompensated Heart Failure
Bikdeli B, Strait KM, Dharmarajan K, Li SX, Mody P, Partovian C, Coca SG, Kim N, Horwitz LI, Testani JM, Krumholz HM. Intravenous Fluids in Acute Decompensated Heart Failure. JACC Heart Failure 2015, 3: 127-133. PMID: 25660836, PMCID: PMC4438991, DOI: 10.1016/j.jchf.2014.09.007.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleFluid TherapyHeart FailureHospital MortalityHospitalizationHumansInfusions, IntravenousIntensive Care UnitsIntubation, IntratrachealIsotonic SolutionsMaleMiddle AgedRenal Replacement TherapyRetrospective StudiesRinger's SolutionSaline Solution, HypertonicSodium Potassium Chloride Symporter InhibitorsUnited StatesYoung AdultConceptsAcute decompensated heart failureDecompensated heart failureHeart failureIntravenous fluidsRetrospective cohort studyCritical care admissionRenal replacement therapyDays of hospitalizationProportion of hospitalizationsHalf-normal salineWarrants further investigationOnly diureticsCare admissionHospital deathHospital outcomesCohort studyLoop diureticsPatient groupReplacement therapyWorse outcomesNormal salineInpatient careMedian volumePatientsHospitalization
2013
Acute Decompensated Heart Failure Is Routinely Treated as a Cardiopulmonary Syndrome
Dharmarajan K, Strait KM, Lagu T, Lindenauer PK, Tinetti ME, Lynn J, Li SX, Krumholz HM. Acute Decompensated Heart Failure Is Routinely Treated as a Cardiopulmonary Syndrome. PLOS ONE 2013, 8: e78222. PMID: 24250751, PMCID: PMC3824040, DOI: 10.1371/journal.pone.0078222.Peer-Reviewed Original ResearchConceptsDecompensated heart failureHeart failureRespiratory therapyHospital daysCardiopulmonary syndromeAcute decompensated heart failureAcute heart failure treatmentChronic obstructive pulmonary diseaseReceipt of medicationHeart failure hospitalizationHigh-dose corticosteroidsHospital day 2Hospital day 3Half of patientsChronic lung diseaseDays of hospitalizationHeart failure treatmentObstructive pulmonary diseaseShortness of breathIntensive care unitPrincipal discharge diagnosisLate intubationAcute asthmaFailure hospitalizationHospital deathIncome 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 analysisDiagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Bernheim SM, Suter LG, Drye EE, Krumholz HM. Diagnoses and Timing of 30-Day Readmissions After Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. JAMA 2013, 309: 355-363. PMID: 23340637, PMCID: PMC3688083, DOI: 10.1001/jama.2012.216476.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCommon readmission diagnosesAcute MI hospitalizationReadmission diagnosesDays of hospitalizationPatient demographic characteristicsHeart failureMyocardial infarctionHF hospitalizationReadmission timingPneumonia hospitalizationsMedian timeMI hospitalizationMedicare feeIndex HF hospitalizationIndex pneumonia hospitalizationProportion of patientsDemographic characteristicsService claims dataMI cohortPneumonia cohortHF cohortCondition categoriesHospitalizationReadmission
2002
Sex differences in cardiac catheterization after acute myocardial infarction: the role of procedure appropriateness.
Rathore SS, Wang Y, Radford MJ, Ordin DL, Krumholz HM. Sex differences in cardiac catheterization after acute myocardial infarction: the role of procedure appropriateness. Annals Of Internal Medicine 2002, 137: 487-93. PMID: 12230349, DOI: 10.7326/0003-4819-137-6-200209170-00008.Peer-Reviewed Original ResearchConceptsCardiac catheterization useAcute myocardial infarctionCardiac catheterizationMyocardial infarctionMultivariable adjustmentEquivocal indicationsSex differencesProcedure useChart-abstracted dataLower crude ratesRisk-standardized ratesU.S. acute care hospitalsDays of hospitalizationAcute care hospitalsClinical guidelinesHospital characteristicsMedicare patientsCrude rateInappropriate treatmentRetrospective analysisCatheterizationInfarctionPatientsElderly personsWomen
1995
Aspirin in the treatment of acute myocardial infarction in elderly Medicare beneficiaries. Patterns of use and outcomes.
Krumholz H, Radford M, Ellerbeck E, Hennen J, Meehan T, Petrillo M, Wang Y, Kresowik T, Jencks S. Aspirin in the treatment of acute myocardial infarction in elderly Medicare beneficiaries. Patterns of use and outcomes. Circulation 1995, 92: 2841-7. PMID: 7586250, DOI: 10.1161/01.cir.92.10.2841.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionUse of aspirinDays of hospitalizationElderly patientsMyocardial infarctionMedicare beneficiariesHospital medical recordsElderly Medicare beneficiariesHigh-risk characteristicsPopulation-based sampleDelivery of careQuality of careAspirin therapyMore comorbiditiesAspirin useChest painAbsolute contraindicationHeart failureThrombolytic therapyPotential confoundersMedical recordsSafe treatmentEffective therapyHigh riskLower odds