2024
Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study
McIntyre D, Quintans D, Kazi S, Min H, He W, Marschner S, Khera R, Nassar N, Chow C. Impact of the COVID-19 pandemic on hospital-based heart failure care in New South Wales, Australia: a linked data cohort study. BMC Health Services Research 2024, 24: 1364. PMID: 39516863, PMCID: PMC11545568, DOI: 10.1186/s12913-024-11840-0.Peer-Reviewed Original ResearchConceptsHeart failure careNew South WalesHospital admissionHealth service utilisationAdministrative health recordsPrimary diagnosis of heart failureData cohort studyRate of admissionPre-pandemicHealth of patientsSouth WalesCOVID-19 pandemicHospital utilisationService utilisationHealth recordsED presentationsMortality dataDiagnosis of heart failureCOVID-19 burdenEmergency departmentCohort studyPrimary diagnosisData collectionCareAustralian dataNatural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure
Adejumo P, Thangaraj P, Dhingra L, Aminorroaya A, Zhou X, Brandt C, Xu H, Krumholz H, Khera R. Natural Language Processing of Clinical Documentation to Assess Functional Status in Patients With Heart Failure. JAMA Network Open 2024, 7: e2443925. PMID: 39509128, PMCID: PMC11544492, DOI: 10.1001/jamanetworkopen.2024.43925.Peer-Reviewed Original ResearchConceptsFunctional status assessmentArea under the receiver operating characteristic curveClinical documentationElectronic health record dataHF symptomsOptimal care deliveryHealth record dataAssess functional statusStatus assessmentClinical trial participationProcessing of clinical documentsFunctional status groupCare deliveryOutpatient careMain OutcomesMedical notesTrial participantsNew York Heart AssociationFunctional statusQuality improvementRecord dataHeart failureClinical notesDiagnostic studiesStatus groupsRacial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic
Faust J, Renton B, Bongiovanni T, Chen A, Sheares K, Du C, Essien U, Fuentes-Afflick E, Haywood T, Khera R, King T, Li S, Lin Z, Lu Y, Marshall A, Ndumele C, Opara I, Loarte-Rodriguez T, Sawano M, Taparra K, Taylor H, Watson K, Yancy C, Krumholz H. Racial and Ethnic Disparities in Age-Specific All-Cause Mortality During the COVID-19 Pandemic. JAMA Network Open 2024, 7: e2438918. PMID: 39392630, PMCID: PMC11581672, DOI: 10.1001/jamanetworkopen.2024.38918.Peer-Reviewed Original ResearchConceptsCOVID-19 public health emergencyNon-HispanicPublic health emergencyOther Pacific IslanderExcess mortalityAlaska NativesUS populationExcess deathsRates of excess mortalityCross-sectional study analyzed dataYears of potential lifeMortality relative riskNon-Hispanic whitesCross-sectional studyPacific IslandersStudy analyzed dataAll-cause mortalityEthnic groupsMortality disparitiesMortality ratioTotal populationDeath certificatesEthnic disparitiesMain OutcomesDecedent age
2021
Association of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry
Rao A, Ranka S, Ayers C, Hendren N, Rosenblatt A, Alger HM, Rutan C, Omar W, Khera R, Gupta K, Mody P, DeFilippi C, Das SR, Hedayati SS, de Lemos JA. Association of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry. Journal Of The American Heart Association 2021, 10: e020910. PMID: 34107743, PMCID: PMC8477855, DOI: 10.1161/jaha.121.020910.Peer-Reviewed Original ResearchConceptsAcute kidney injuryMajor adverse cardiac eventsAdverse cardiac eventsChronic kidney diseaseCardiac eventsKidney diseaseCause mortalityAmerican Heart Association COVID-19 Cardiovascular Disease RegistryCOVID-19Major adverse cardiovascular eventsEnd-stage kidney diseaseCardiovascular Disease RegistryLarge multicenter registryNonfatal heart failureSerial laboratory dataAdverse cardiovascular eventsNonfatal myocardial infarctionKey secondary outcomesCardiovascular disease outcomesPrimary exposure variableNonfatal strokeCardiogenic shockCardiovascular deathCardiovascular eventsCardiovascular outcomesOut‐of‐pocket Annual Health Expenditures and Financial Toxicity from Healthcare Costs in Patients with Heart Failure in the United States
Wang SY, Valero‐Elizondo J, Ali H, Pandey A, Cainzos‐Achirica M, Krumholz HM, Nasir K, Khera R. Out‐of‐pocket Annual Health Expenditures and Financial Toxicity from Healthcare Costs in Patients with Heart Failure in the United States. Journal Of The American Heart Association 2021, 10: e022164. PMID: 33998273, PMCID: PMC8483501, DOI: 10.1161/jaha.121.022164.Peer-Reviewed Original ResearchConceptsGreater risk-adjusted oddsRisk-adjusted oddsHeart failureMedical Expenditure Panel SurveyCatastrophic financial burdenPocket healthcare expensesHigh financial burdenFinancial toxicityHealthcare expensesFinancial burdenHealthcare costsCatastrophic burdenMajor public health burdenLow-income familiesBackground Heart failurePublic health burdenInsurance premiumsPanel SurveyPocket healthcare costsAnnual health expenditureWorld Health OrganizationConclusions PatientsHealth insurance premiumsPocket healthcare expenditureHealth burdenPerformance of the Pooled Cohort Equations in Hispanic Individuals Across the United States: Insights From the Multi‐Ethnic Study of Atherosclerosis and the Dallas Heart Study
Rosario K, Mehta A, Ayers C, Gonzalez P, Pandey A, Khera R, Kaplan R, Blaha MJ, Khera A, Blumenthal RS, Nasir K, Rodriguez CJ, Joshi PH. Performance of the Pooled Cohort Equations in Hispanic Individuals Across the United States: Insights From the Multi‐Ethnic Study of Atherosclerosis and the Dallas Heart Study. Journal Of The American Heart Association 2021, 10: e018410. PMID: 33870702, PMCID: PMC8200750, DOI: 10.1161/jaha.120.018410.Commentaries, Editorials and LettersAssociation of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19
Khera R, Clark C, Lu Y, Guo Y, Ren S, Truax B, Spatz ES, Murugiah K, Lin Z, Omer SB, Vojta D, Krumholz HM. Association of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19. Journal Of The American Heart Association 2021, 10: e018086. PMID: 33624516, PMCID: PMC8403305, DOI: 10.1161/jaha.120.018086.Peer-Reviewed Original ResearchConceptsAngiotensin receptor blockersLower hospitalization riskACE inhibitorsCOVID-19 hospitalizationHospitalization riskHospital mortalityReceptor blockersValidation cohortAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionEnzyme inhibitorsSyndrome coronavirus 2 infectionAngiotensin converting enzyme (ACE) inhibitorsCoronavirus 2 infectionRisk of hospitalizationCoronavirus disease-19SARS-CoV-2COVID-19 preventionHypertensive patientsInpatient cohortOutpatient cohortContemporary cohortStudy cohortOutpatient studyMedicare group
2020
Temporal Trends in Heart Failure Incidence Among Medicare Beneficiaries Across Risk Factor Strata, 2011 to 2016
Khera R, Kondamudi N, Zhong L, Vaduganathan M, Parker J, Das SR, Grodin JL, Halm EA, Berry JD, Pandey A. Temporal Trends in Heart Failure Incidence Among Medicare Beneficiaries Across Risk Factor Strata, 2011 to 2016. JAMA Network Open 2020, 3: e2022190. PMID: 33095250, PMCID: PMC7584929, DOI: 10.1001/jamanetworkopen.2020.22190.Peer-Reviewed Original ResearchConceptsHeart failure incidenceHF risk factorsHF incidenceClinical Modification codesRisk factorsAcute MIMedicare beneficiariesFailure incidenceHF prevention strategiesRisk factor strataNational cohort studyService Medicare beneficiariesUnique Medicare beneficiariesInternational Statistical ClassificationRace/ethnicityPrior HFPrevalent hypertensionCohort studyIncident HFNinth RevisionPrevious diagnosisCardiovascular conditionsTenth RevisionMAIN OUTCOMEInternational ClassificationTemporal Trends in Racial Differences in 30-Day Readmission and Mortality Rates After Acute Myocardial Infarction Among Medicare Beneficiaries
Pandey A, Keshvani N, Khera R, Lu D, Vaduganathan M, Maddox K, Das SR, Kumbhani DJ, Goyal A, Girotra S, Chan P, Fonarow GC, Matsouaka R, Wang TY, de Lemos JA. Temporal Trends in Racial Differences in 30-Day Readmission and Mortality Rates After Acute Myocardial Infarction Among Medicare Beneficiaries. JAMA Cardiology 2020, 5: 136-145. PMID: 31913411, PMCID: PMC6990949, DOI: 10.1001/jamacardio.2019.4845.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionNonblack patientsMyocardial infarctionReadmission ratesMortality rateBlack patientsChest Pain-MI RegistryThirty-day readmission ratesRacial disparitiesExcess readmission ratiosPenalty statusObservational cohort analysisPatient-level factorsRacial differencesReadmissions Reduction ProgramHigher unadjusted oddsHRRP implementationCause readmissionPatient characteristicsUnadjusted oddsBlack raceThirty-dayAdjusted associationsReadmission ratiosReadmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure
Ko DT, Khera R, Lau G, Qiu F, Wang Y, Austin PC, Koh M, Lin Z, Lee DS, Wijeysundera HC, Krumholz HM. Readmission and Mortality After Hospitalization for Myocardial Infarction and Heart Failure. Journal Of The American College Of Cardiology 2020, 75: 736-746. PMID: 32081282, DOI: 10.1016/j.jacc.2019.12.026.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overFemaleHeart FailureHumansMaleMyocardial InfarctionOntarioPatient ReadmissionRetrospective StudiesConceptsAcute myocardial infarctionPost-discharge mortalityHospital mortalityReadmission ratesHospitalization ratesMyocardial infarctionMortality rateRisk-adjusted mortality ratesHospital Readmissions Reduction ProgramHF hospitalization ratesHeart failure hospitalizationPatients 65 yearsReadmissions Reduction ProgramFailure hospitalizationHF patientsSecondary outcomesHospital readmissionPrimary outcomeReadmissionMortalityAMI hospitalization ratesStudy periodPattern of outcomesHospitalizationOutcomesPost-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
Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak association
2018
Hospital Variation in the Utilization and Implementation of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest
Khera R, Humbert A, Leroux B, Nichol G, Kudenchuk P, Scales D, Baker A, Austin M, Newgard CD, Radecki R, Vilke GM, Sawyer KN, Sopko G, Idris AH, Wang H, Chan PS, Kurz MC. Hospital Variation in the Utilization and Implementation of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004829. PMID: 30571336, DOI: 10.1161/circoutcomes.118.004829.Peer-Reviewed Original ResearchConceptsTargeted temperature managementHospital cardiac arrestCardiac arrestMedian rateResuscitation Outcomes Consortium sitesHospital cardiac arrest patientsImproved functional survivalMedian hospital rateClass I recommendationPotential survival benefitResuscitation Outcomes ConsortiumNon-traumatic outCardiac arrest patientsTemperature managementPatterns of utilizationConsecutive adultsHospital arrivalProspective cohortSurvival benefitArrest patientsHospital variationI recommendationMean ageOutcomes ConsortiumResuscitation guidelinesAssociation Between Financial Burden, Quality of Life, and Mental Health Among Those With Atherosclerotic Cardiovascular Disease in the United States
Annapureddy A, Valero-Elizondo J, Khera R, Grandhi GR, Spatz ES, Dreyer RP, Desai NR, Krumholz HM, Nasir K. Association Between Financial Burden, Quality of Life, and Mental Health Among Those With Atherosclerotic Cardiovascular Disease in the United States. Circulation Cardiovascular Quality And Outcomes 2018, 11: e005180. PMID: 30571331, DOI: 10.1161/circoutcomes.118.005180.Peer-Reviewed Original ResearchTrends in 30-Day Readmission Rates for Medicare and Non-Medicare Patients in the Era of the Affordable Care Act
Angraal S, Khera R, Zhou S, Wang Y, Lin Z, Dharmarajan K, Desai NR, Bernheim SM, Drye EE, Nasir K, Horwitz LI, Krumholz HM. Trends in 30-Day Readmission Rates for Medicare and Non-Medicare Patients in the Era of the Affordable Care Act. The American Journal Of Medicine 2018, 131: 1324-1331.e14. PMID: 30016636, PMCID: PMC6380174, DOI: 10.1016/j.amjmed.2018.06.013.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramReadmission ratesAcute myocardial infarctionHeart failurePatient groupMyocardial infarctionCause readmission rateNationwide Readmissions DatabaseReadmissions Reduction ProgramNon-Medicare patientsNon-target conditionsLower readmissionAffordable Care ActMedicare beneficiariesAge groupsPrivate insuranceCare ActPneumoniaInfarctionPatientsReduction programsMedicareGroupReadmissionFailureAssociation of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia
Khera R, Dharmarajan K, Wang Y, Lin Z, Bernheim SM, Wang Y, Normand ST, Krumholz HM. Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia. JAMA Network Open 2018, 1: e182777. PMID: 30646181, PMCID: PMC6324473, DOI: 10.1001/jamanetworkopen.2018.2777.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramAcute myocardial infarctionPostdischarge mortalityHeart failureHRRP announcementReadmissions Reduction ProgramMedicare beneficiariesRisk-adjusted ratesMyocardial infarctionService Medicare beneficiariesReduction programsInterrupted time series frameworkHospital mortalityReduced readmissionsCohort studyPneumonia hospitalizationsReadmission ratesMAIN OUTCOMEPneumoniaMedicare dataHospitalizationHospitalMortalityReadmissionConcomitant harmIncreasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014
Rubens M, Saxena A, Ramamoorthy V, Das S, Khera R, Hong J, Armaignac D, Veledar E, Nasir K, Gidel L. Increasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014. Journal Of Intensive Care Medicine 2018, 35: 858-868. PMID: 30175649, DOI: 10.1177/0885066618794136.Peer-Reviewed Original ResearchComparison of Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Implantation
Kumar N, Khera R, Fonarow GC, Bhatt DL. Comparison of Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Implantation. The American Journal Of Cardiology 2018, 122: 1520-1526. PMID: 30190074, DOI: 10.1016/j.amjcard.2018.07.025.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAge DistributionAged, 80 and overBlood TransfusionCohort StudiesDatabases, FactualFemaleHeart FailureHospital MortalityHumansLength of StayMalePacemaker, ArtificialPeripheral Vascular DiseasesPrevalencePropensity ScoreStrokeTranscatheter Aortic Valve ReplacementUnited StatesConceptsTranscatheter aortic valve implantationAcute kidney injuryTA-TAVI proceduresAortic valve implantationTF-TAVIHospital mortalityTA-TAVIPostoperative strokeTransapical approachValve implantationTAVI procedureTA TAVIReal-world patient populationTA-TAVI groupTF-TAVI groupPropensity-matched cohortPeripheral vascular diseasePropensity-matched pairsComparison of outcomesTF approachICD-9 procedureLower ratesTA approachKidney injuryBaseline characteristicsSex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014
Angraal S, Khera R, Wang Y, Lu Y, Jean R, Dreyer RP, Geirsson A, Desai NR, Krumholz HM. Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014. Journal Of The American Heart Association 2018, 7: e009014. PMID: 30005557, PMCID: PMC6064835, DOI: 10.1161/jaha.118.009014.Peer-Reviewed Original ResearchConceptsCoronary artery bypassCABG utilizationArtery bypassUse of CABGService Medicare beneficiariesCalendar year trendsCABG mortalityUnderwent CABGReadmission ratesCABG proceduresWhite patientsBlack patientsPatient groupMedicare beneficiariesMedicare feeMortality rateCABGAnnual declineWomenRacial subgroupsRacial differencesGreater declineOutcomesPatientsSexAnnual Burden and Costs of Hospitalization for High-Need, High-Cost Patients With Chronic Gastrointestinal and Liver Diseases
Nguyen NH, Khera R, Ohno-Machado L, Sandborn WJ, Singh S. Annual Burden and Costs of Hospitalization for High-Need, High-Cost Patients With Chronic Gastrointestinal and Liver Diseases. Clinical Gastroenterology And Hepatology 2018, 16: 1284-1292.e30. PMID: 29474966, PMCID: PMC6056327, DOI: 10.1016/j.cgh.2018.02.015.Peer-Reviewed Original ResearchConceptsFunctional gastrointestinal disordersChronic liver diseaseInflammatory bowel diseaseHigh-cost patientsCost of hospitalizationGastrointestinal hemorrhageLiver diseasePancreatic diseaseChronic gastrointestinalHospitalization costsAnnual burdenNationwide Readmissions Database 2013Medicare/Medicaid insuranceHigher comorbidity burdenInfection-related hospitalizationNationwide database analysisMultivariate logistic regressionDays/monthLarge rural hospitalPopulation health managementLow-income statusCardiopulmonary causesComorbidity burdenIndex hospitalizationHigh-value care