2023
Changes in Older Adult Trauma Quality When Evaluated Using Longer-Term Outcomes vs In-Hospital Mortality
Zogg C, Cooper Z, Peduzzi P, Falvey J, Castillo-Angeles M, Kodadek L, Staudenmayer K, Davis K, Tinetti M, Lichtman J. Changes in Older Adult Trauma Quality When Evaluated Using Longer-Term Outcomes vs In-Hospital Mortality. JAMA Surgery 2023, 158: e234856. PMID: 37792354, PMCID: PMC10551815, DOI: 10.1001/jamasurg.2023.4856.Peer-Reviewed Original ResearchConceptsHospital-level factorsTraumatic brain injurySevere traumatic brain injuryHospital mortalityTrauma QualityOlder adultsHip fractureComposite scoreHigher risk-adjusted oddsLevel 1 trauma centerIn-Hospital MortalityRisk-adjusted oddsLong-term outcomesMultivariable logistic regressionNontrauma centersTrauma patientsTerm outcomesTrauma centerPrimary diagnosisBrain injuryTrauma systemMAIN OUTCOMEMedicare feeService claimsForms of traumaOutcomes after ischemic stroke for dual-eligible Medicare-Medicaid beneficiaries in the United States
Leifheit E, Wang Y, Goldstein L, Lichtman J. Outcomes after ischemic stroke for dual-eligible Medicare-Medicaid beneficiaries in the United States. PLOS ONE 2023, 18: e0292546. PMID: 37797070, PMCID: PMC10553827, DOI: 10.1371/journal.pone.0292546.Peer-Reviewed Original ResearchConceptsStroke hospitalization ratesMedicare beneficiariesIschemic strokeHospitalization ratesUS acute care hospitalsDual-eligible patientsLong-term mortalityUS Medicare beneficiariesIschemic stroke hospitalizationsPost-stroke outcomesAcute care hospitalsService Medicare beneficiariesDual-eligible statusDual-eligible beneficiariesPercentage of beneficiariesCause readmissionHigher readmissionClinical factorsDual eligibilityAdjusted analysisPoor outcomeStroke patientsCox regressionStroke hospitalizationsPrincipal diagnosisAssociation of short-term hospital-level outcome metrics with 1-year mortality and recurrence for US Medicare beneficiaries with ischemic stroke
Wang Y, Leifheit E, Goldstein L, Lichtman J. Association of short-term hospital-level outcome metrics with 1-year mortality and recurrence for US Medicare beneficiaries with ischemic stroke. PLOS ONE 2023, 18: e0289790. PMID: 37561680, PMCID: PMC10414659, DOI: 10.1371/journal.pone.0289790.Peer-Reviewed Original ResearchConceptsIschemic strokeInverse probability weightsStroke patientsCause mortalityOutcome metricsLower riskUS hospitalsBetter long-term outcomesRecurrent stroke rateIschemic stroke recurrenceIschemic stroke patientsLong-term outcomesUS Medicare beneficiariesPerformance categoriesIntermediate hospitalsRecurrent strokeStroke recurrenceCohort studyClinical factorsRecurrence ratePrincipal diagnosisPatient riskStroke rateReadmission measuresCox modelAssociations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke
Tran P, Warren J, Leifheit E, Goldstein L, Lichtman J. Associations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke. Stroke 2023, 54: e126-e129. PMID: 36729388, PMCID: PMC11059199, DOI: 10.1161/strokeaha.122.042265.Peer-Reviewed Original ResearchConceptsLong-term air pollutant exposureAir pollutant exposureCause hospital readmissionHospital readmissionPollutant exposureMedicare beneficiaries agePerformance categoriesMatter 2.5Sulfur dioxide exposureCause readmission measureIschemic strokeStroke incidenceUS patientsHospital characteristicsSD increaseReadmissionCox modelReadmission measuresBeneficiaries ageLong-term exposureStrokePatientsMedicaid ServicesParticulate matter 2.5US fee
2012
30-Day Risk-Standardized Mortality and Readmission Rates After Ischemic Stroke in Critical Access Hospitals
Lichtman JH, Leifheit-Limson EC, Jones SB, Wang Y, Goldstein LB. 30-Day Risk-Standardized Mortality and Readmission Rates After Ischemic Stroke in Critical Access Hospitals. Stroke 2012, 43: 2741-2747. PMID: 22935397, PMCID: PMC3547601, DOI: 10.1161/strokeaha.112.665646.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesRisk-standardized readmission ratesAnnual hospital volumeIschemic strokeReadmission ratesHospital volumeVolume quartileHighest risk-standardized mortality ratesPoor short-term outcomeMedicare beneficiaries 65 yearsService Medicare beneficiaries 65 yearsHighest volume quartileHospital volume quartilesPrimary discharge diagnosisLow-volume hospitalsShort-term outcomesBeneficiaries 65 years
2011
30-Day Mortality and Readmission After Hemorrhagic Stroke Among Medicare Beneficiaries in Joint Commission Primary Stroke Center-Certified and Noncertified Hospitals
Lichtman JH, Jones SB, Leifheit-Limson EC, Wang Y, Goldstein LB. 30-Day Mortality and Readmission After Hemorrhagic Stroke Among Medicare Beneficiaries in Joint Commission Primary Stroke Center-Certified and Noncertified Hospitals. Stroke 2011, 42: 3387-3391. PMID: 22033986, PMCID: PMC3292255, DOI: 10.1161/strokeaha.111.622613.Peer-Reviewed Original ResearchConceptsSubarachnoid hemorrhageIntracerebral hemorrhageReadmission ratesHemorrhagic strokeMedicare beneficiariesJoint Commission Primary Stroke CentersLower risk-adjusted mortality ratesCox proportional hazards regressionRisk-adjusted readmission ratesRisk-adjusted mortality ratesIschemic stroke patientsPrimary discharge diagnosisPrimary stroke centerProportional hazards regressionService Medicare beneficiariesEffects of careHospital mortalityStroke centersStroke patientsDischarge diagnosisHazards regressionMortality rateBetter outcomesHospitalPatientsOutcomes after ischemic stroke for hospitals with and without Joint Commission–certified primary stroke centers
Lichtman JH, Jones SB, Wang Y, Watanabe E, Leifheit-Limson E, Goldstein LB. Outcomes after ischemic stroke for hospitals with and without Joint Commission–certified primary stroke centers. Neurology 2011, 76: 1976-1982. PMID: 21543736, PMCID: PMC3109877, DOI: 10.1212/wnl.0b013e31821e54f3.Peer-Reviewed Original ResearchConceptsPrimary stroke centerRisk-standardized mortalityJoint CommissionPSC hospitalsIschemic strokeReadmission ratesStroke centersService Medicare beneficiariesHospital referral regionsIschemic stroke dischargesPSC certificationPatient demographicsComorbid conditionsStudy cohortMortality outcomesNational averagePrimary diagnosisReferral regionsMedicare beneficiariesHierarchical linear regression modelsHospitalStroke dischargesLinear regression modelsLower ratesStroke
2010
Use of Antithrombotic Medications Among Elderly Ischemic Stroke Patients
Lichtman JH, Naert L, Allen NB, Watanabe E, Jones SB, Barry LC, Bravata DM, Goldstein LB. Use of Antithrombotic Medications Among Elderly Ischemic Stroke Patients. Circulation Cardiovascular Quality And Outcomes 2010, 4: 30-38. PMID: 21098780, PMCID: PMC3073519, DOI: 10.1161/circoutcomes.109.850883.Peer-Reviewed Original ResearchConceptsDeep vein thrombosis prophylaxisElderly ischemic stroke patientsIschemic stroke patientsThrombosis prophylaxisAntithrombotic medicationSkilled nursing facilitiesEligible patientsAntithrombotic therapyIschemic strokeAtrial fibrillationStroke patientsNursing facilitiesPatients ages 85 yearsSecondary stroke preventionAge 85 yearsRates of receiptLow treatment ratesRate of treatmentAntiplatelet medicationsStroke preventionEffect of agePatient agePatient characteristicsAntiplatelet drugsMedicare feeTrends in One-Year Recurrent Ischemic Stroke among the Elderly in the USA: 1994–2002
Allen NB, Holford TR, Bracken MB, Goldstein LB, Howard G, Wang Y, Lichtman JH. Trends in One-Year Recurrent Ischemic Stroke among the Elderly in the USA: 1994–2002. Cerebrovascular Diseases 2010, 30: 525-532. PMID: 20881382, PMCID: PMC2978738, DOI: 10.1159/000319028.Peer-Reviewed Original ResearchThe Role of Social Support in Health Status and Depressive Symptoms After Acute Myocardial Infarction
Leifheit-Limson EC, Reid KJ, Kasl SV, Lin H, Jones PG, Buchanan DM, Parashar S, Peterson PN, Spertus JA, Lichtman JH. The Role of Social Support in Health Status and Depressive Symptoms After Acute Myocardial Infarction. Circulation Cardiovascular Quality And Outcomes 2010, 3: 143-150. PMID: 20160162, PMCID: PMC3016989, DOI: 10.1161/circoutcomes.109.899815.Peer-Reviewed Original ResearchMeSH KeywordsAgedAngina PectorisChi-Square DistributionDepressionEvidence-Based MedicineFemaleHealth StatusHealth Status IndicatorsHumansLinear ModelsMaleMiddle AgedMyocardial InfarctionPoisson DistributionProspective StudiesQuality of LifeRegistriesRisk AssessmentRisk FactorsSex FactorsSocial SupportTime FactorsUnited StatesWomen's HealthWomen's Health ServicesConceptsAcute myocardial infarctionLow social supportDisease-specific qualityDepressive symptomsMyocardial infarctionHealth statusPhysical functioningLower disease-specific qualitySocial supportBaseline health statusBaseline depressive symptomsWorse health statusRisk of anginaLower physical functioningMyocardial infarction recoverySex-stratified associationsLower mental functioningSex-stratified analysesMore depressive symptomsFirst yearClinical factorsProspective studyNonsignificant trendSymptomsInfarction
2009
Hospital Arrival Time and Intravenous t-PA Use in US Academic Medical Centers, 2001–2004
Lichtman JH, Watanabe E, Allen NB, Jones SB, Dostal J, Goldstein LB. Hospital Arrival Time and Intravenous t-PA Use in US Academic Medical Centers, 2001–2004. Stroke 2009, 40: 3845-3850. PMID: 19797697, DOI: 10.1161/strokeaha.109.562660.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedAged, 80 and overBlack or African AmericanBrain IschemiaEmergency Medical ServicesEmergency Service, HospitalFemaleHealth Services AccessibilityHumansInjections, IntravenousIntracranial ThrombosisMaleMiddle AgedQuality of Health CareSeverity of Illness IndexStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTransportation of PatientsUnited StatesWhite PeopleConceptsIschemic stroke patientsSymptom onsetT-PA useStroke patientsHospital arrivalIntravenous tissue-type plasminogen activatorConsecutive ischemic stroke patientsEarly hospital arrivalPercentage of patientsUS academic centersHospital arrival timeRisk-adjusted analysisMultivariate logistic regressionCare-seeking behaviorAcademic medical centerTissue-type plasminogen activatorClinical characteristicsSevere strokePatient characteristicsBlack patientsEmergency departmentMedical recordsHospital careMedical CenterLower oddsStroke Patient Outcomes in US Hospitals Before the Start of the Joint Commission Primary Stroke Center Certification Program
Lichtman JH, Allen NB, Wang Y, Watanabe E, Jones SB, Goldstein LB. Stroke Patient Outcomes in US Hospitals Before the Start of the Joint Commission Primary Stroke Center Certification Program. Stroke 2009, 40: 3574-3579. PMID: 19797179, PMCID: PMC2782858, DOI: 10.1161/strokeaha.109.561472.Peer-Reviewed Original ResearchConceptsPrimary stroke centerCross-sectional studyBetter outcomesJoint CommissionHospital mortalityStroke centersCox proportional hazards modelStroke center certificationStroke patient outcomesProportional hazards modelYears of ageHierarchical logistic regressionIschemic strokeCenter certificationPatient outcomesMedicare feeHazards modelUS hospitalsService beneficiariesHospitalLogistic regressionPatientsMortalityRisk adjustmentStudy sampleDiagnostic Evaluation for Patients with Ischemic Stroke: Are There Sex Differences?
Watanabe E, Allen NB, Dostal J, Sama D, Claus EB, Goldstein LB, Lichtman JH. Diagnostic Evaluation for Patients with Ischemic Stroke: Are There Sex Differences? Cerebrovascular Diseases 2009, 27: 450-455. PMID: 19295208, DOI: 10.1159/000209240.Peer-Reviewed Original ResearchConceptsIschemic stroke patientsStroke patientsIschemic strokeAcademic hospitalDiagnostic evaluationConsecutive ischemic stroke patientsDiagnostic testsAcute coronary symptomsCarotid artery ultrasoundManagement of womenUS academic medical centersMultivariate logistic regressionUse of neuroimagingAcademic medical centerUS academic hospitalsSex-associated differencesSex differencesClinical factorsCoronary symptomsPotential confoundersMedical recordsCarotid arteryMedical CenterPatientsLogistic regressionElderly Women Have Lower Rates of Stroke, Cardiovascular Events, and Mortality After Hospitalization for Transient Ischemic Attack
Lichtman JH, Jones SB, Watanabe E, Allen NB, Wang Y, Howard VJ, Goldstein LB. Elderly Women Have Lower Rates of Stroke, Cardiovascular Events, and Mortality After Hospitalization for Transient Ischemic Attack. Stroke 2009, 40: 2116-2122. PMID: 19228857, PMCID: PMC2757938, DOI: 10.1161/strokeaha.108.543009.Peer-Reviewed Original ResearchConceptsTransient ischemic attackCoronary artery diseaseArtery diseaseIschemic attackCardiovascular eventsOutcomes 30 daysService Medicare patientsRisk-adjusted analysisProportional hazards modelYears of ageRandom effects logistic modelSex-related differencesSex-based differencesCardiac comorbiditiesTIA admissionsCause readmissionElderly patientsHospital dischargePrior hospitalizationBetter prognosisUnadjusted ratesMedical historyElderly womenMedicare patientsHazards modelThe joint contribution of sex, age and type of myocardial infarction on hospital mortality following acute myocardial infarction
Champney K, Frederick P, Bueno H, Parashar S, Foody J, Merz C, Canto J, Lichtman J, Vaccarino V, Investigators F. The joint contribution of sex, age and type of myocardial infarction on hospital mortality following acute myocardial infarction. Heart 2009, 95: 895. PMID: 19147625, PMCID: PMC3065924, DOI: 10.1136/hrt.2008.155804.Peer-Reviewed Original ResearchConceptsNon-ST elevation MIST-elevation MIElevation myocardial infarctionMyocardial infarctionNSTEMI patientsNon-ST elevation myocardial infarctionST-elevation myocardial infarctionRetrospective cohort studyExcess mortality riskShort-term mortalityAcute myocardial infarctionSex-related differencesHospital mortalityUnadjusted RRHospital deathCohort studyPatient ageExcess riskNational registryHospital participantsMAIN OUTCOMEMortality riskOlder womenAge 50Better survival
2001
Utilization of Intravenous Tissue-Type Plasminogen Activator for Ischemic Stroke at Academic Medical Centers
Johnston S, Fung L, Gillum L, Smith W, Brass L, Lichtman J, Brown A. Utilization of Intravenous Tissue-Type Plasminogen Activator for Ischemic Stroke at Academic Medical Centers. Stroke 2001, 32: 1061-1068. PMID: 11340210, DOI: 10.1161/01.str.32.5.1061.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedBlack or African AmericanBrain IschemiaCohort StudiesContraindicationsDatabases, FactualDrug Utilization ReviewFemaleFibrinolytic AgentsHumansLogistic ModelsMaleMiddle AgedPatient DischargeStrokeThrombolytic TherapyTissue Plasminogen ActivatorUnited StatesWhite PeopleConceptsAcademic medical centerTissue-type plasminogen activatorIschemic strokeMedical CenterIntravenous tissue-type plasminogen activatorConsecutive ischemic stroke casesAfrican AmericansPlasminogen activatorIschemic stroke patientsUS academic medical centersMultivariable logistic regressionMedical insuranceIschemic stroke casesMedical insurance typePrivate medical insuranceTPA useStroke severityStroke patientsStroke casesMedical historyInsurance typeMedical recordsUnivariate analysisContraindicationsLogistic regressionCan Practice Guidelines Be Transported Effectively to Different Settings? Results from a Multicenter Interventional Study
Lichtman J, Roumanis S, Radford M, Riedinger M, Weingarten S, Krumholz H. Can Practice Guidelines Be Transported Effectively to Different Settings? Results from a Multicenter Interventional Study. The Joint Commission Journal On Quality And Patient Safety 2001, 27: 42-53. PMID: 11147239, DOI: 10.1016/s1070-3241(01)27005-9.Peer-Reviewed Original ResearchMeSH KeywordsAgedChest PainConnecticutFollow-Up StudiesHealth Care SurveysHospitalizationHumansInterviews as TopicMaleMiddle AgedNebraskaNorth CarolinaOutcome Assessment, Health CarePatient DischargePatient SatisfactionPennsylvaniaPractice Guidelines as TopicProspective StudiesSouth CarolinaSurveys and QuestionnairesConceptsChest painClinical guidelinesIntervention periodGuideline adherenceGuideline implementationPatient outcomesLow-risk chest pain patientsLow-risk chest painStandardized protocolMulticenter interventional studyLow-risk patientsChest pain patientsInterventional trialsPain patientsSuccessful translationClinical outcomesGuideline periodInterventional studyPatient satisfactionPatient's physicianPractice guidelinesHospital settingBaseline valuesClinical practicePain
2000
Intracranial Hemorrhage Associated With Thrombolytic Therapy for Elderly Patients With Acute Myocardial Infarction
Brass L, Lichtman J, Wang Y, Gurwitz J, Radford M, Krumholz H. Intracranial Hemorrhage Associated With Thrombolytic Therapy for Elderly Patients With Acute Myocardial Infarction. Stroke 2000, 31: 1802-1811. PMID: 10926938, DOI: 10.1161/01.str.31.8.1802.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionThrombolytic therapyIntracranial hemorrhageMyocardial infarctionElderly patientsIntracranial Hemorrhage AssociatedRetrospective cohort studyRisk stratification scaleMain outcome measuresAcute care hospitalsTissue plasminogen activatorExcessive anticoagulationPrior strokeCohort studyOlder patientsBlood pressureHemorrhage AssociatedIndependent predictorsMedical chartsSerious complicationsMedian weightAlternate therapyBlack racePrincipal diagnosisMedicare patients