2022
Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015
Guo W, Du X, Gao Y, Hu S, Lu Y, Dreyer RP, Li X, Spatz ES, Masoudi FA, Krumholz HM, Zheng X. Sex Differences in Characteristics, Treatments, and Outcomes Among Patients Hospitalized for Non–ST-Segment–Elevation Myocardial Infarction in China: 2006 to 2015. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008535. PMID: 35607994, PMCID: PMC9208815, DOI: 10.1161/circoutcomes.121.008535.Peer-Reviewed Original ResearchConceptsSegment elevation myocardial infarctionInvasive strategyMyocardial infarctionHospital mortalityHospital outcomesMultivariable logistic regression modelCardiovascular risk factorsElevation myocardial infarctionSex-related disparitiesQuality of careProportion of womenLogistic regression modelsSex differencesClinical characteristicsClinical profileRisk factorsClinical covariatesSex-specific differencesPatientsInfarctionST segmentSex gapChinese hospitalsMortalityWomen
2021
Use of Machine Learning Models to Predict Death After Acute Myocardial Infarction
Khera R, Haimovich J, Hurley NC, McNamara R, Spertus JA, Desai N, Rumsfeld JS, Masoudi FA, Huang C, Normand SL, Mortazavi BJ, Krumholz HM. Use of Machine Learning Models to Predict Death After Acute Myocardial Infarction. JAMA Cardiology 2021, 6: 633-641. PMID: 33688915, PMCID: PMC7948114, DOI: 10.1001/jamacardio.2021.0122.Peer-Reviewed Original ResearchConceptsMachine learning modelsMeta-classifier modelLearning modelNeural networkGradient descent boostingAcute myocardial infarctionContemporary machineGradient descentXGBoost modelXGBoostHospital mortalityCohort studyLogistic regressionMyocardial infarctionNetworkChest Pain-MI RegistryPrecise classificationIndependent validation dataInitial laboratory valuesNovel methodLarge national registryHigh-risk individualsData analysisValidation dataResolution of riskClinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection
McPadden J, Warner F, Young HP, Hurley NC, Pulk RA, Singh A, Durant TJS, Gong G, Desai N, Haimovich A, Taylor RA, Gunel M, Dela Cruz CS, Farhadian SF, Siner J, Villanueva M, Churchwell K, Hsiao A, Torre CJ, Velazquez EJ, Herbst RS, Iwasaki A, Ko AI, Mortazavi BJ, Krumholz HM, Schulz WL. Clinical characteristics and outcomes for 7,995 patients with SARS-CoV-2 infection. PLOS ONE 2021, 16: e0243291. PMID: 33788846, PMCID: PMC8011821, DOI: 10.1371/journal.pone.0243291.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionYale New Haven HealthSARS-CoV-2Hospital mortalityRisk of admissionMale sexRisk factorsSARS-CoV-2 testingInvasive mechanical ventilationSevere acute respiratory syndrome virusBurden of diseaseRT-PCR testingAcademic health systemDiverse patient populationsRespiratory syndrome virusEthnic groupsAdult patientsClinical characteristicsDischarge dispositionRespiratory supportPrimary outcomeTreatment guidelinesMechanical ventilationRetrospective studyPatient populationAssociation between antecedent statin use and decreased mortality in hospitalized patients with COVID-19
Gupta A, Madhavan MV, Poterucha TJ, DeFilippis EM, Hennessey JA, Redfors B, Eckhardt C, Bikdeli B, Platt J, Nalbandian A, Elias P, Cummings MJ, Nouri SN, Lawlor M, Ranard LS, Li J, Boyle C, Givens R, Brodie D, Krumholz HM, Stone GW, Sethi SS, Burkhoff D, Uriel N, Schwartz A, Leon MB, Kirtane AJ, Wan EY, Parikh SA. Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19. Nature Communications 2021, 12: 1325. PMID: 33637713, PMCID: PMC7910606, DOI: 10.1038/s41467-021-21553-1.Peer-Reviewed Original ResearchConceptsAcute respiratory distress syndromeStatin usePrimary endpointCOVID-19Multivariable logistic regression modelStudy periodLower inpatient mortalityPropensity-matched cohortRespiratory distress syndromeCoronavirus disease 2019Electronic medical recordsLogistic regression modelsPropensity-score matchingHospital mortalityHyperinflammatory stateOutpatient medicationsClinical characteristicsInpatient mortalityStatin usersThrombotic complicationsDistress syndromeHospitalized patientsMyocardial injuryMedical recordsRetrospective analysisAssociation 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
Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults
Ding Q, Spatz ES, Lipska KJ, Lin H, Spertus JA, Dreyer RP, Whittemore R, Funk M, Bueno H, Krumholz HM. Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults. Heart 2020, 107: 657-666. PMID: 33082173, PMCID: PMC8005796, DOI: 10.1136/heartjnl-2020-317101.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth statusDischarge diagnosisPharmacological treatmentMyocardial infarctionShort-term health statusYoung AMI Patients (VIRGO) studyDisease-specific health statusYoung adultsQuality of lifeHospital complicationsHospital mortalityMedication initiationBaseline characteristicsClinical outcomesDiabetesPatientsDiagnosisPatient studiesMonthsComplicationsInfarctionSignificant differencesOutcomesMortalityRevascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018
Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Internal Medicine 2020, 180: 1317-1327. PMID: 32833024, PMCID: PMC9377424, DOI: 10.1001/jamainternmed.2020.3276.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCoronary VesselsFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPatient DischargePercutaneous Coronary InterventionRisk AssessmentRisk FactorsShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionMultivessel percutaneous coronary interventionMultivessel coronary artery diseasePercutaneous coronary interventionAcute myocardial infarctionCoronary artery diseaseCulprit vessel percutaneous coronary interventionCardiogenic shockHospital mortalityArtery diseaseMyocardial infarctionCohort studyPrimary outcomeHospital variationPCI strategyMedicare beneficiariesUnderwent multivessel PCISignificant hospital variationElevation myocardial infarctionSubset of patientsHigh-risk populationRecent evidenceHospital complicationsPCI useRevascularization practiceGeographic Variation in Process and Outcomes of Care for Patients With Acute Myocardial Infarction in China From 2001 to 2015
Zhong Q, Gao Y, Zheng X, Chen J, Masoudi FA, Lu Y, Feng Y, Hu S, Zhang Q, Huang C, Wang Y, Krumholz HM, Li X, Zhou Y. Geographic Variation in Process and Outcomes of Care for Patients With Acute Myocardial Infarction in China From 2001 to 2015. JAMA Network Open 2020, 3: e2021182. PMID: 33095248, PMCID: PMC7584924, DOI: 10.1001/jamanetworkopen.2020.21182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionProcess of careHospital mortalityMyocardial infarctionOdds ratioAngiotensin receptor blockersCross-sectional studyOutcomes of careReceptor blockersReperfusion therapyPatient characteristicsTherapy useCare measuresPatient hospitalizationIdeal patientOutcome measuresMAIN OUTCOMEΒ-blockersAMI managementPatientsEnzyme inhibitorsSignificant geographic variationMortalityCareHospitalizationAssociation of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock
Dhruva SS, Ross JS, Mortazavi BJ, Hurley NC, Krumholz HM, Curtis JP, Berkowitz A, Masoudi FA, Messenger JC, Parzynski CS, Ngufor C, Girotra S, Amin AP, Shah ND, Desai NR. Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock. JAMA 2020, 323: 734-745. PMID: 32040163, PMCID: PMC7042879, DOI: 10.1001/jama.2020.0254.Peer-Reviewed Original ResearchMeSH KeywordsAgedCause of DeathExtracorporeal Membrane OxygenationFemaleHeart ArrestHeart-Assist DevicesHemorrhageHospital MortalityHumansIntra-Aortic Balloon PumpingMaleMatched-Pair AnalysisMiddle AgedMyocardial InfarctionPercutaneous Coronary InterventionPropensity ScoreRegistriesRetrospective StudiesShock, CardiogenicST Elevation Myocardial InfarctionConceptsMicroaxial left ventricular assist deviceIntra-aortic balloon pumpLeft ventricular assist deviceAcute myocardial infarctionPercutaneous coronary interventionNational Cardiovascular Data RegistryCardiogenic shockHemodynamic supportMyocardial infarctionRegistry-based retrospective cohort studyCardiology-National Cardiovascular Data RegistryChest Pain-MI RegistryST-elevation myocardial infarctionMechanical circulatory support devicesGreater hemodynamic supportHospital major bleedingRetrospective cohort studyPropensity-matched pairsCirculatory support devicesVentricular assist deviceClinical laboratory dataHospital mortalityMajor bleedingHospital deathCohort studyReadmission 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 ResearchConceptsAcute 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 outcomesHospitalizationOutcomes
2019
The relationship between off-hours admissions for primary percutaneous coronary intervention, door-to-balloon time and mortality for patients with ST-elevation myocardial infarction in England: a registry-based prospective national cohort study
Jayawardana S, Salas-Vega S, Cornehl F, Krumholz HM, Mossialos E. The relationship between off-hours admissions for primary percutaneous coronary intervention, door-to-balloon time and mortality for patients with ST-elevation myocardial infarction in England: a registry-based prospective national cohort study. BMJ Quality & Safety 2019, 29: 541-549. PMID: 31831635, PMCID: PMC7362773, DOI: 10.1136/bmjqs-2019-010067.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionOff-hours admissionPercutaneous coronary interventionDTB timeCoronary interventionBalloon timeST-elevation myocardial infarction (STEMI) patientsElevation myocardial infarction patientsProspective national cohort studyST-elevation myocardial infarctionCent of admissionsMedian DTB timeOff-hour effectPatient risk factorsProspective observational studyRecords of patientsPrimary outcome measureNational cohort studyTimeliness of careMyocardial infarction patientsHierarchical logistic regression modelsLogistic regression modelsHospital mortalityCohort studySecondary outcomesCharacteristics, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: The China PEACE Retrospective Heart Failure Study
Yu Y, Gupta A, Wu C, Masoudi FA, Du X, Zhang J, Krumholz HM, Li J, Group T. Characteristics, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: The China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2019, 8: e012884. PMID: 31431117, PMCID: PMC6755852, DOI: 10.1161/jaha.119.012884.Peer-Reviewed Original ResearchConceptsHeart failureHF careSignificant healthcare resource utilizationBackground Heart failureGuideline-recommended medicationsLower inpatient mortalityAcute heart failureOutcomes of patientsHealthcare resource utilizationLower prescription ratesMedical record abstractionHeart Failure StudyTraditional Chinese medicineHospital mortalityConclusions PatientsInpatient mortalityPatient characteristicsTreatment withdrawalEjection fractionMedian agePrescription ratesRecord abstractionMedian lengthBiomarker testingInpatient settingTwenty-Year Trends in Outcomes for Older Adults With Acute Myocardial Infarction in the United States
Krumholz HM, Normand ST, Wang Y. Twenty-Year Trends in Outcomes for Older Adults With Acute Myocardial Infarction in the United States. JAMA Network Open 2019, 2: e191938. PMID: 30874787, PMCID: PMC6484647, DOI: 10.1001/jamanetworkopen.2019.1938.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRecurrent acute myocardial infarctionPercutaneous coronary interventionAMI dischargeCause readmissionCoronary interventionMyocardial infarctionMedicare feeCoronary artery bypass graft surgery ratesCoronary artery bypass graft surgeryArtery bypass graft surgeryInpatient percutaneous coronary interventionRate of catheterizationBypass graft surgeryShort-term mortalityInpatient paymentsQuality of careTwenty-year trendsEvolution of outcomesHospital mortalityHospital stayInpatient outcomesCause mortalityGraft surgeryCohort study
2018
Association 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 harm
2017
National Trends in Use and Outcomes of Pulmonary Artery Catheters Among Medicare Beneficiaries, 1999-2013
Ikuta K, Wang Y, Robinson A, Ahmad T, Krumholz HM, Desai NR. National Trends in Use and Outcomes of Pulmonary Artery Catheters Among Medicare Beneficiaries, 1999-2013. JAMA Cardiology 2017, 2: 908-913. PMID: 28593267, PMCID: PMC5815078, DOI: 10.1001/jamacardio.2017.1670.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCatheterization, Swan-GanzCohort StudiesCross-Sectional StudiesDisease ManagementFemaleHeart FailureHospital MortalityHospitalizationHumansLength of StayMaleMedicareMortalityMyocardial InfarctionPulmonary ArteryRespiratory InsufficiencyUnited StatesVascular Access DevicesConceptsAcute myocardial infarctionLength of stayPAC usePAC placementRespiratory failureHeart failureMyocardial infarctionClinical conditionsPulmonary artery catheter useNational trendsCross-sectional cohort studyStudy periodKey clinical conditionsMedicaid Services inpatientHeart failure admissionsPulmonary artery catheterClinical Modification codesSociodemographic groupsUnique Medicare beneficiariesLack of benefitRace/ethnicityService inpatientsHospital mortalityCatheter useArtery catheterAssociation of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge
Dharmarajan K, Wang Y, Lin Z, Normand ST, Ross JS, Horwitz LI, Desai NR, Suter LG, Drye EE, Bernheim SM, Krumholz HM. Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge. JAMA 2017, 318: 270-278. PMID: 28719692, PMCID: PMC5817448, DOI: 10.1001/jama.2017.8444.Peer-Reviewed Original ResearchConceptsRisk-adjusted readmission ratesRisk-adjusted mortality ratesAcute myocardial infarctionHeart failureReadmission ratesMortality rateMyocardial infarctionMedicare feeService beneficiariesHospital readmission ratesMean hospitalHospital mortalityPostdischarge mortalityHospital dischargeHospital readmissionRetrospective studyAffordable Care ActReadmission reductionMAIN OUTCOMEPneumoniaHospitalSecondary analysisWeighted Pearson correlation coefficientMortalityCare ActTrends in mortality and major complications for patients undergoing coronary artery bypass grafting among Urban Teaching Hospitals in China: 2004 to 2013
Yuan X, Zhang H, Zheng Z, Rao C, Zhao Y, Wang Y, Krumholz HM, Hu S. Trends in mortality and major complications for patients undergoing coronary artery bypass grafting among Urban Teaching Hospitals in China: 2004 to 2013. European Heart Journal - Quality Of Care And Clinical Outcomes 2017, 3: 312-318. PMID: 29044398, PMCID: PMC5805118, DOI: 10.1093/ehjqcco/qcx021.Peer-Reviewed Original ResearchConceptsMajor complication rateUrban teaching hospitalCoronary artery bypassComplication rateHospital mortalityTeaching hospitalArtery bypassMean ageChinese Cardiac Surgery RegistryAge groupsAnnual CABG volumePost-operative LOSPatients' mean ageCardiac Surgery RegistryPatient characteristicsCardiac surgeryMajor complicationsNumber of hospitalsCABG volumeTotal LOSHospitalMortalityPatientsRegistry systemMixed effects modelsComparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States
Zheng Z, Zhang H, Yuan X, Rao C, Zhao Y, Wang Y, Normand SL, Krumholz HM, Hu S. Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003327. PMID: 28611187, PMCID: PMC5482563, DOI: 10.1161/circoutcomes.116.003327.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedChinaCoronary Artery BypassCoronary Artery DiseaseFemaleHealthcare DisparitiesHospital Bed CapacityHospital MortalityHospitals, High-VolumeHospitals, TeachingHospitals, UrbanHumansLength of StayMaleMiddle AgedOdds RatioPrevalenceProcess Assessment, Health CarePropensity ScoreQuality Indicators, Health CareRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesYoung AdultConceptsIsolated CABG surgeryCoronary artery bypassUrban hospitalHospital mortalityArtery bypassCABG surgeryChinese Cardiac Surgery RegistryTotal hospital stayCardiac Surgery RegistryCoronary artery diseaseNational Inpatient SampleLarge teachingLength of staySignificant mortality differenceHospital staySecondary outcomesArtery diseasePrimary outcomeMedian lengthComparing outcomesInpatient SampleMortality differencesHigher ageHigh mortalityHospital
2016
China PEACE risk estimation tool for in-hospital death from acute myocardial infarction: an early risk classification tree for decisions about fibrinolytic therapy
Li X, Li J, Masoudi FA, Spertus JA, Lin Z, Krumholz HM, Jiang L. China PEACE risk estimation tool for in-hospital death from acute myocardial infarction: an early risk classification tree for decisions about fibrinolytic therapy. BMJ Open 2016, 6: e013355. PMID: 27798032, PMCID: PMC5093680, DOI: 10.1136/bmjopen-2016-013355.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionAcute myocardial infarctionFibrinolytic therapyLow-risk groupMyocardial infarctionHospital deathHospital mortalitySegment elevation myocardial infarctionCardiac Events (PEACE) studyHospital death riskComposite of deathElevation myocardial infarctionSystolic blood pressureTime of presentationRelative risk reductionCross-sectional studyBaseline mortality riskAcute reperfusionMajor bleedingReperfusion therapyBlood pressureDerivation cohortStudy cohortChina PatientValidation cohortAssociation Between Hospital Performance on Patient Safety and 30‐Day Mortality and Unplanned Readmission for Medicare Fee‐for‐Service Patients With Acute Myocardial Infarction
Wang Y, Eldridge N, Metersky ML, Sonnenfeld N, Fine JM, Pandolfi MM, Eckenrode S, Bakullari A, Galusha DH, Jaser L, Verzier NR, Nuti SV, Hunt D, Normand S, Krumholz HM. Association Between Hospital Performance on Patient Safety and 30‐Day Mortality and Unplanned Readmission for Medicare Fee‐for‐Service Patients With Acute Myocardial Infarction. Journal Of The American Heart Association 2016, 5: e003731. PMID: 27405808, PMCID: PMC5015406, DOI: 10.1161/jaha.116.003731.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCause of DeathCenters for Medicare and Medicaid Services, U.S.Fee-for-Service PlansFemaleHospitalsHospitals, RuralHospitals, VoluntaryHumansMaleMedicareMortalityMyocardial InfarctionPatient ReadmissionPatient SafetyPrognosisUnited StatesUnited States Agency for Healthcare Research and QualityConceptsAcute myocardial infarctionUnplanned readmission rateMedicare Patient Safety Monitoring SystemRisk-standardized mortalityAdverse eventsReadmission ratesService patientsMedicare feeUnplanned readmissionMyocardial infarctionMedicare patientsPatient safetyHospital performanceMore adverse eventsAdverse event ratesAcute care hospitalsPatient safety dataHospital mortalityAdverse event measuresCause mortalityOccurrence rateCare hospitalHospital characteristicsReadmission dataPatient safety performance