2019
Modeling defibrillation benefit for survival among cardiac resynchronization therapy defibrillator recipients
Bilchick KC, Wang Y, Curtis JP, Cheng A, Dharmarajan K, Shadman R, Dardas TF, Anand I, Lund LH, Dahlström U, Sartipy U, Maggioni A, O'Connor C, Levy WC. Modeling defibrillation benefit for survival among cardiac resynchronization therapy defibrillator recipients. American Heart Journal 2019, 222: 93-104. PMID: 32032927, PMCID: PMC7814502, DOI: 10.1016/j.ahj.2019.12.017.Peer-Reviewed Original ResearchConceptsCRT-D patientsImplantable cardioverter defibrillatorSurvival benefitCRT-DsCardiac resynchronization therapy defibrillator recipientsCardiac resynchronization therapy candidatesSeattle Heart Failure ModelSeattle Proportional Risk ModelCox proportional hazards regressionNational Cardiovascular Data RegistryHeart Failure TrialHeart failure patientsProportional hazards regressionHeart failure modelProportional risk modelFailure patientsCRT candidatesHeart failureCRT pacemakerFailure TrialArrhythmic deathHazards regressionDefibrillator recipientsCRT deviceCardioverter defibrillatorThirty-Day Hospital Readmission After Acute Myocardial Infarction in China
Li J, Dharmarajan K, Bai X, Masoudi FA, Spertus JA, Li X, Zheng X, Zhang H, Yan X, Dreyer RP, Krumholz HM, Group F. Thirty-Day Hospital Readmission After Acute Myocardial Infarction in China. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005628. PMID: 31092023, DOI: 10.1161/circoutcomes.119.005628.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionUnplanned cardiovascular readmissionsDays of dischargeMyocardial infarctionCardiovascular readmissionCause readmissionMost readmissionsLower riskFit Cox proportional hazards modelsST-segment elevation myocardial infarctionAcute Coronary Events (GRACE) scoreThirty-day hospital readmissionsDisease-specific health statusCox proportional hazards modelVentricular ejection fractionProportional hazards modelLow social supportBackground ReadmissionRecurrent anginaCardiovascular eventsHospital complicationsUnplanned readmissionIndex hospitalizationClinical factorsConsecutive patientsRisk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study
Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. Journal Of The American Medical Directors Association 2019, 20: 432-437. PMID: 30954133, PMCID: PMC6486375, DOI: 10.1016/j.jamda.2019.01.135.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesSNF dischargeRetrospective cohort studySNF lengthHeart failureHF hospitalizationComposite outcomeCohort studyNursing facilitiesService beneficiaries 65Heart failure hospitalizationRisk of readmissionHazard rate ratiosFailure hospitalizationUnplanned readmissionHF diagnosisHospital dischargePostdischarge outcomesSNF stayMedicare patientsMedicare feeHome transitionPatientsReadmissionDay 3
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 outcomesPredicting death after acute myocardial infarction
Castro-Dominguez Y, Dharmarajan K, McNamara RL. Predicting death after acute myocardial infarction. Trends In Cardiovascular Medicine 2017, 28: 102-109. PMID: 28826668, DOI: 10.1016/j.tcm.2017.07.011.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionRisk factorsClinical presentation characteristicsRisk stratification modelImportant risk factorPatients important informationPatient riskClinical informationStratification modelPresentation characteristicsMortalityInfarctionRiskHospitalizationPrognosisCliniciansSeattle Heart Failure and Proportional Risk Models Predict Benefit From Implantable Cardioverter-Defibrillators
Bilchick KC, Wang Y, Cheng A, Curtis JP, Dharmarajan K, Stukenborg GJ, Shadman R, Anand I, Lund LH, Dahlström U, Sartipy U, Maggioni A, Swedberg K, O’Conner C, Levy WC. Seattle Heart Failure and Proportional Risk Models Predict Benefit From Implantable Cardioverter-Defibrillators. Journal Of The American College Of Cardiology 2017, 69: 2606-2618. PMID: 28545633, PMCID: PMC5502749, DOI: 10.1016/j.jacc.2017.03.568.Peer-Reviewed Original ResearchConceptsSeattle Heart Failure ModelSeattle Proportional Risk ModelNational Cardiovascular Data RegistryPrimary prevention ICDsHeart failureSudden deathCause mortalitySurvival benefitMultivariable Cox proportional hazards regressionCox proportional hazards regressionProportional riskProportional hazards regressionRecent clinical trialsHeart failure modelProportional risk modelControl patientsOverall survivalVentricular arrhythmiasHazards regressionICD benefitClinical trialsCardioverter defibrillatorLarge cohortHigh riskData registrySex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia
Dreyer RP, Dharmarajan K, Hsieh AF, Welsh J, Qin L, Krumholz HM. Sex Differences in Trajectories of Risk After Rehospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003271. PMID: 28506980, PMCID: PMC5650228, DOI: 10.1161/circoutcomes.116.003271.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionHeart failureReadmission riskDaily riskImmediate postdischarge periodRisk of rehospitalizationSex differencesDeath 1 yearPrincipal discharge diagnosisHospitalization of patientsAssociation of sexRehospitalization riskPostdischarge periodDischarge diagnosisMedicare patientsHigh riskMortality riskMedicare feeTrajectories of riskRehospitalizationInfarctionService beneficiariesHospitalizationPneumonia
2016
Analysis of Machine Learning Techniques for Heart Failure Readmissions
Mortazavi BJ, Downing NS, Bucholz EM, Dharmarajan K, Manhapra A, Li SX, Negahban SN, Krumholz HM. Analysis of Machine Learning Techniques for Heart Failure Readmissions. Circulation Cardiovascular Quality And Outcomes 2016, 9: 629-640. PMID: 28263938, PMCID: PMC5459389, DOI: 10.1161/circoutcomes.116.003039.Peer-Reviewed Original ResearchDeclining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time
Dharmarajan K, Qin L, Lin Z, Horwitz LI, Ross JS, Drye EE, Keshawarz A, Altaf F, Normand SL, Krumholz HM, Bernheim SM. Declining Admission Rates And Thirty-Day Readmission Rates Positively Associated Even Though Patients Grew Sicker Over Time. Health Affairs 2016, 35: 1294-1302. PMID: 27385247, DOI: 10.1377/hlthaff.2015.1614.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCenters for Medicare and Medicaid Services, U.S.Chronic DiseaseDatabases, FactualDisease ProgressionFemaleGeriatric AssessmentHospital MortalityHumansIncidenceLength of StayMaleOutcome Assessment, Health CarePatient AdmissionPatient ReadmissionRetrospective StudiesRisk AssessmentSeverity of Illness IndexTime FactorsUnited StatesOutcomes 1 Year After Implantable Cardioverter–Defibrillator Lead Abandonment Versus Explantation for Unused or Malfunctioning Leads
Zeitler EP, Wang Y, Dharmarajan K, Anstrom KJ, Peterson ED, Daubert JP, Curtis JP, Al-Khatib SM. Outcomes 1 Year After Implantable Cardioverter–Defibrillator Lead Abandonment Versus Explantation for Unused or Malfunctioning Leads. Circulation Arrhythmia And Electrophysiology 2016, 9: e003953. PMID: 27406605, PMCID: PMC4973616, DOI: 10.1161/circep.116.003953.Peer-Reviewed Original ResearchConceptsNational Cardiovascular Data Registry ICD RegistryLead explantationUpper extremity thrombosisProcedure-related complicationsImplantable cardioverter-defibrillator leadsOutcomes 1 yearLong-term safetyCardioverter-defibrillator leadsHospital complicationsHospital deathUrgent surgeryPulmonary embolismICD RegistryHospital eventsPostprocedure complicationsMortality riskPatientsICD leadPropensity scoreComplicationsExplantationLead abandonmentMalfunctioning leadsHigh rateComparative acute
2015
Hospital variation in admission to intensive care units for patients with acute myocardial infarction
Chen R, Strait KM, Dharmarajan K, Li SX, Ranasinghe I, Martin J, Fazel R, Masoudi FA, Cooke CR, Nallamothu BK, Krumholz HM. Hospital variation in admission to intensive care units for patients with acute myocardial infarction. American Heart Journal 2015, 170: 1161-1169. PMID: 26678638, PMCID: PMC5459386, DOI: 10.1016/j.ahj.2015.09.003.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnterior Wall Myocardial InfarctionCoronary Care UnitsHealth Care RationingHospital MortalityHumansLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionQuality ImprovementRetrospective StudiesRisk AssessmentTriageUnited StatesConceptsAcute myocardial infarctionIntensive care unitCritical care therapiesRisk-standardized mortality ratesHospital risk-standardized mortality ratesICU admissionResource-intensive settingsCare therapyAMI patientsCare unitMyocardial infarctionMortality rateAdult hospitalizationsHospital variationNinth RevisionClinical ModificationICU triageInternational ClassificationBetter outcomesPatientsHospitalAdmissionPremier databaseTherapyAppropriate useTrajectories 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
2014
National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010
Chaudhry SI, Khan RF, Chen J, Dharmarajan K, Dodson JA, Masoudi FA, Wang Y, Krumholz HM. National Trends in Recurrent AMI Hospitalizations 1 Year After Acute Myocardial Infarction in Medicare Beneficiaries: 1999–2010. Journal Of The American Heart Association 2014, 3: e001197. PMID: 25249298, PMCID: PMC4323804, DOI: 10.1161/jaha.114.001197.Peer-Reviewed Original Research
2013
Dominance of Furosemide for Loop Diuretic Therapy in Heart Failure Time to Revisit the Alternatives?
Bikdeli B, Strait KM, Dharmarajan K, Partovian C, Coca SG, Kim N, Li SX, Testani JM, Khan U, Krumholz HM. Dominance of Furosemide for Loop Diuretic Therapy in Heart Failure Time to Revisit the Alternatives? Journal Of The American College Of Cardiology 2013, 61: 1549-1550. PMID: 23500272, PMCID: PMC4038646, DOI: 10.1016/j.jacc.2012.12.043.Peer-Reviewed Original ResearchMost Important Outcomes Research Papers on Variation in Cardiovascular Disease
Lampropulos JF, Gupta A, Kulkarni VT, Mody P, Chen R, Bikdeli B, Dharmarajan K. Most Important Outcomes Research Papers on Variation in Cardiovascular Disease. Circulation Cardiovascular Quality And Outcomes 2013, 6: e9-e16. PMID: 23481532, DOI: 10.1161/circoutcomes.113.000185.Peer-Reviewed Original ResearchAge FactorsCardiovascular DiseasesGuideline AdherenceHealth Services ResearchHealthcare DisparitiesHumansOutcome and Process Assessment, Health CarePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareResidence CharacteristicsRisk AssessmentRisk FactorsTreatment Outcome
2012
Most Important Outcomes Research Papers on Valvular Heart Disease
Lampropulos JF, Bikdeli B, Gupta A, Mody P, Kulkarni VT, Chen R, Dharmarajan K. Most Important Outcomes Research Papers on Valvular Heart Disease. Circulation Cardiovascular Quality And Outcomes 2012, 5: e95-e103. PMID: 23170009, DOI: 10.1161/circoutcomes.112.969766.Peer-Reviewed Original ResearchMost Important Outcomes Research Papers on Anticoagulation for Cardiovascular Disease
Bikdeli B, Gupta A, Mody P, Lampropulos JF, Dharmarajan K. Most Important Outcomes Research Papers on Anticoagulation for Cardiovascular Disease. Circulation Cardiovascular Quality And Outcomes 2012, 5: e65-e74. PMID: 22991352, DOI: 10.1161/circoutcomes.112.968701.Peer-Reviewed Original ResearchMost Important Articles on Cardiovascular Disease Among Racial and Ethnic Minorities
Mody P, Gupta A, Bikdeli B, Lampropulos JF, Dharmarajan K. Most Important Articles on Cardiovascular Disease Among Racial and Ethnic Minorities. Circulation Cardiovascular Quality And Outcomes 2012, 5: e33-e41. PMID: 22811508, DOI: 10.1161/circoutcomes.112.967638.Peer-Reviewed Original ResearchProcedure Intensity and the Cost of Care
Chen SI, Dharmarajan K, Kim N, Strait KM, Li SX, Safavi KC, Lindenauer PK, Krumholz HM, Lagu T. Procedure Intensity and the Cost of Care. Circulation Cardiovascular Quality And Outcomes 2012, 5: 308-313. PMID: 22576844, PMCID: PMC3415230, DOI: 10.1161/circoutcomes.112.966069.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCosts and Cost AnalysisCross-Sectional StudiesFemaleHeart FailureHospital Bed CapacityHospital CostsHospital MortalityHospitalizationHospitals, RuralHospitals, TeachingHospitals, UrbanHumansLength of StayLinear ModelsMaleMiddle AgedModels, EconomicOutcome and Process Assessment, Health CareResidence CharacteristicsRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsHF hospitalizationHeart failureInvasive proceduresHospital groupRisk-standardized mortality ratesProportion of patientsLength of stayCost of careWilcoxon rank sum testHigher procedure ratesRank sum testPatient demographicsPerspective databaseMedian lengthSurgical proceduresProcedure ratesHospitalizationOutcome differencesMortality rateHospitalPatientsPractice styleProcedure useSum testOverall useMost Important Outcomes Research Papers in Cardiovascular Disease in the Elderly
Gupta A, Mody P, Bikdeli B, Lampropulos JF, Dharmarajan K. Most Important Outcomes Research Papers in Cardiovascular Disease in the Elderly. Circulation Cardiovascular Quality And Outcomes 2012, 5: e17-e26. PMID: 22592757, DOI: 10.1161/circoutcomes.112.966531.Peer-Reviewed Original Research