2024
Illusory generalizability of clinical prediction models
Chekroud A, Hawrilenko M, Loho H, Bondar J, Gueorguieva R, Hasan A, Kambeitz J, Corlett P, Koutsouleris N, Krumholz H, Krystal J, Paulus M. Illusory generalizability of clinical prediction models. Science 2024, 383: 164-167. PMID: 38207039, DOI: 10.1126/science.adg8538.Peer-Reviewed Original Research
2022
Study protocol for the Innovative Support for Patients with SARS-COV-2 Infections Registry (INSPIRE): A longitudinal study of the medium and long-term sequelae of SARS-CoV-2 infection
O’Laughlin K, Thompson M, Hota B, Gottlieb M, Plumb ID, Chang AM, Wisk LE, Hall AJ, Wang RC, Spatz ES, Stephens KA, Huebinger RM, McDonald SA, Venkatesh A, Gentile N, Slovis BH, Hill M, Saydah S, Idris AH, Rodriguez R, Krumholz HM, Elmore JG, Weinstein RA, Nichol G, . Study protocol for the Innovative Support for Patients with SARS-COV-2 Infections Registry (INSPIRE): A longitudinal study of the medium and long-term sequelae of SARS-CoV-2 infection. PLOS ONE 2022, 17: e0264260. PMID: 35239680, PMCID: PMC8893622, DOI: 10.1371/journal.pone.0264260.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionLong-term sequelaePatient-reported outcomesRelative riskAcute SARS-CoV-2 infectionSARS-CoV-2 negative participantsHealth system encountersPredictors of sequelaeHealth recordsInstitutional review board approvalLongitudinal studyDigital health recordsReview board approvalSARS-CoV-2Secure online platformClinical outcomesStudy protocolNegative participantsViral testsSimilar symptomatologyNew diagnosisBoard approvalSequelaeSelf-administered surveyInfection
2021
Clinical 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 populationImpact of ST‐Segment–Elevation Myocardial Infarction Regionalization Programs on the Treatment and Outcomes of Patients Diagnosed With Non–ST‐Segment–Elevation Myocardial Infarction
Montoy JCC, Shen Y, Brindis RG, Krumholz HM, Hsia RY. Impact of ST‐Segment–Elevation Myocardial Infarction Regionalization Programs on the Treatment and Outcomes of Patients Diagnosed With Non–ST‐Segment–Elevation Myocardial Infarction. Journal Of The American Heart Association 2021, 10: e016932. PMID: 33470136, PMCID: PMC7955417, DOI: 10.1161/jaha.120.016932.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCaliforniaCoronary AngiographyEarly DiagnosisElectrocardiographyFemaleFollow-Up StudiesHospitalizationHumansMaleMiddle AgedNon-ST Elevated Myocardial InfarctionPercutaneous Coronary InterventionPrognosisProgram EvaluationRegistriesRetrospective StudiesRisk FactorsST Elevation Myocardial InfarctionSurvival RateTreatment OutcomeConceptsOutcomes of patientsEarly angiographyMyocardial infarctionST segmentST-segment elevation myocardial infarctionSegment elevation myocardial infarctionProportion of patientsElevation myocardial infarctionRisk of deathRisk of mortalityRegionalization programIndex admissionEmergency departmentRegionalized careNonfederal hospitalsMAIN OUTCOMETimely carePatientsAngiographyOverall populationNSTEMIInfarctionStudy periodMortalityCare
2020
Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017
Mori M, Wang Y, Murugiah K, Khera R, Gupta A, Vallabhajosyula P, Masoudi FA, Geirsson A, Krumholz HM. Trends in Reoperative Coronary Artery Bypass Graft Surgery for Older Adults in the United States, 1998 to 2017. Journal Of The American Heart Association 2020, 9: e016980. PMID: 33045889, PMCID: PMC7763387, DOI: 10.1161/jaha.120.016980.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryFirst-time coronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryGraft surgeryMedicare feeOlder adultsPatient baseline characteristicsData of adultsYear of dischargeProportion of womenService inpatientsIndex surgeryBaseline characteristicsHospital dischargeOlder patientsMedian agePrimary outcomeCox regressionService patientsUnique patientsPatientsSurgeryAnnual declineDemographic subgroups
2019
Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study.
Dodson JA, Hajduk AM, Geda M, Krumholz HM, Murphy TE, Tsang S, Tinetti ME, Nanna MG, McNamara R, Gill TM, Chaudhry SI. Predicting 6-Month Mortality for Older Adults Hospitalized With Acute Myocardial Infarction: A Cohort Study. Annals Of Internal Medicine 2019, 172: 12-21. PMID: 31816630, PMCID: PMC7695040, DOI: 10.7326/m19-0974.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI mortalityFunctional impairmentOlder adultsCohort studyMean ageMyocardial infarctionPatient-reported health statusNet reclassification improvement indexProspective cohort studyParticipants' mean ageFinal risk modelMobility impairmentsGood discriminatory abilityRisk modelChart reviewHospital dischargePrognostic utilityBlood InstituteClinical variablesNational HeartHigh prevalenceHealth statusMortalityYounger counterpartsInterplay of Coronary Artery Calcium and Risk Factors for Predicting CVD/CHD Mortality The CAC Consortium
Grandhi GR, Mirbolouk M, Dardari ZA, Al-Mallah MH, Rumberger JA, Shaw LJ, Blankstein R, Miedema MD, Berman DS, Budoff MJ, Krumholz HM, Blaha MJ, Nasir K. Interplay of Coronary Artery Calcium and Risk Factors for Predicting CVD/CHD Mortality The CAC Consortium. JACC Cardiovascular Imaging 2019, 13: 1175-1186. PMID: 31734198, DOI: 10.1016/j.jcmg.2019.08.024.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCause of DeathComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseDiabetes MellitusDyslipidemiasFemaleHeart Disease Risk FactorsHumansHypertensionMaleMiddle AgedMultidetector Computed TomographyPredictive Value of TestsPrevalencePrognosisRetrospective StudiesRisk AssessmentSmokingTime FactorsUnited StatesVascular CalcificationConceptsCoronary artery calciumCoronary heart diseaseRisk factorsCause-specific mortalityRF burdenCause mortalityArtery calciumCAC scoreCVD mortalityAbsence of CACHigher CAC scoresCHD mortality ratesCurrent cigarette smokingCardiovascular disease deathsCAC ConsortiumCAC testingMulticenter cohortCigarette smokingDisease deathsHeart diseasePrognostic informationBaseline riskFamily historyMost deathsMortality rateUsefulness of Social Support in Older Adults After Hospitalization for Acute Myocardial Infarction (from the SILVER-AMI Study)
Green YS, Hajduk AM, Song X, Krumholz HM, Sinha SK, Chaudhry SI. Usefulness of Social Support in Older Adults After Hospitalization for Acute Myocardial Infarction (from the SILVER-AMI Study). The American Journal Of Cardiology 2019, 125: 313-319. PMID: 31787249, PMCID: PMC7003680, DOI: 10.1016/j.amjcard.2019.10.038.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPost-AMI outcomesMyocardial infarctionIndependent associationMedical Outcomes Study Social Support SurveySocial supportOlder AMI patientsSocial Support SurveyParticipants 75 yearsLow emotional supportLow social supportImportant social determinantInitial hospitalizationOlder patientsDevelopment of interventionsAMI patientsMultivariable analysisMean ageMultivariable regressionHealth outcomesSupport SurveyInformational supportReadmissionSocial determinantsOlder adultsMachine Learning Prediction of Mortality and Hospitalization in Heart Failure With Preserved Ejection Fraction
Angraal S, Mortazavi BJ, Gupta A, Khera R, Ahmad T, Desai NR, Jacoby DL, Masoudi FA, Spertus JA, Krumholz HM. Machine Learning Prediction of Mortality and Hospitalization in Heart Failure With Preserved Ejection Fraction. JACC Heart Failure 2019, 8: 12-21. PMID: 31606361, DOI: 10.1016/j.jchf.2019.06.013.Peer-Reviewed Original ResearchConceptsHF hospitalizationRisk of mortalityEjection fractionBlood urea nitrogen levelsLogistic regressionPrevious HF hospitalizationHeart failure hospitalizationReduced ejection fractionReceiver-operating characteristic curveRisk of deathBody mass indexBlood urea nitrogenUrea nitrogen levelsHealth status dataMean c-statisticKCCQ scoresTOPCAT trialFailure hospitalizationHeart failureHemoglobin levelsMass indexC-statisticHospitalizationUrea nitrogenMortalityAssociation of Diabetes Mellitus With Health Status Outcomes in Young Women and Men After Acute Myocardial Infarction: Results From the VIRGO Study
Ding Q, Funk M, Spatz ES, Whittemore R, Lin H, Lipska KJ, Dreyer RP, Spertus JA, Krumholz HM. Association of Diabetes Mellitus With Health Status Outcomes in Young Women and Men After Acute Myocardial Infarction: Results From the VIRGO Study. Journal Of The American Heart Association 2019, 8: e010988. PMID: 31441351, PMCID: PMC6755841, DOI: 10.1161/jaha.118.010988.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsDiabetes MellitusFemaleHealth StatusHealth Status IndicatorsHumansMaleMental HealthMiddle AgedMyocardial InfarctionPatient Reported Outcome MeasuresPredictive Value of TestsPrevalencePrognosisQuality of LifeRecovery of FunctionRisk AssessmentRisk FactorsSex FactorsSpainTime FactorsUnited StatesYoung AdultConceptsAcute myocardial infarctionEuroQol visual analogue scaleSeattle Angina QuestionnaireDiabetes mellitusForm Health SurveyHealth status outcomesHealth statusVIRGO StudyAnalog scaleMyocardial infarctionHealth SurveyStatus outcomesYoung adultsSAQ angina frequencyCardiovascular risk factorsHealth status scoresRisk of mortalityWorse health statusPoor health statusQuality of lifeWorse anginaAngina QuestionnaireClinical characteristicsHealthcare useStatus scoreMyocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population
Dreyer RP, Tavella R, Curtis JP, Wang Y, Pauspathy S, Messenger J, Rumsfeld JS, Maddox TM, Krumholz HM, Spertus JA, Beltrame JF. Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population. European Heart Journal 2019, 41: 870-878. PMID: 31222249, PMCID: PMC7778433, DOI: 10.1093/eurheartj/ehz403.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsAcute myocardial infarctionHeart failureMyocardial infarctionCoronary angiographyComponents of MACENational Cardiovascular Data Registry CathPCI RegistryNon-obstructive coronary arteriesObstructive coronary artery diseaseAdverse cardiac eventsMajor adverse eventsObservational cohort studyObstructive coronary diseasePrognosis of patientsCoronary artery diseaseMACE componentsMINOCA patientsAdjusted riskCause mortalityPrimary endpointSecondary endpointsAdverse eventsCardiac eventsCathPCI RegistryCohort studyAcute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study
Dodson JA, Hajduk A, Curtis J, Geda M, Krumholz HM, Song X, Tsang S, Blaum C, Miller P, Parikh CR, Chaudhry SI. Acute Kidney Injury Among Older Patients Undergoing Coronary Angiography for Acute Myocardial Infarction: The SILVER-AMI Study. The American Journal Of Medicine 2019, 132: e817-e826. PMID: 31170374, PMCID: PMC6891160, DOI: 10.1016/j.amjmed.2019.05.022.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAcute Kidney InjuryAge FactorsAgedAged, 80 and overCohort StudiesCoronary AngiographyDatabases, FactualFemaleGeriatric AssessmentHospital MortalityHospitalizationHumansKaplan-Meier EstimateLogistic ModelsMaleMyocardial InfarctionOdds RatioPrognosisProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSurvival AnalysisConceptsAcute kidney injuryAcute myocardial infarctionAge-related conditionsKidney injuryBody mass indexCoronary angiographyRisk factorsMyocardial infarctionOlder patientsMean ageAcute kidney injury risk factorsAcute Myocardial Infarction StudyAcute myocardial infarction cohortOlder adultsGlobal Outcomes criteriaMyocardial Infarction StudyInjury risk factorsParticipants' mean ageSILVER-AMI StudyMultivariable adjustmentComorbid diseasesHeart failureIndependent predictorsGeriatric conditionsMass index
2018
Sex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study
Dreyer RP, Zheng X, Xu X, Liu S, Li J, Ding Q, Du X, Li X, Zhang H, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Sex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study. European Heart Journal Acute Cardiovascular Care 2018, 8: 273-282. PMID: 30270637, DOI: 10.1177/2048872618803726.Peer-Reviewed Original ResearchConceptsMajor adverse cardiac eventsDisease-specific health statusAdverse cardiac eventsAcute myocardial infarctionGeneric health statusMyocardial infarctionCardiac eventsFemale sexHealth statusWeekly anginaChina PatientHealth outcomesAcute Myocardial Infarction StudyPost-acute myocardial infarctionAcute myocardial infarction patientsLong-term health outcomesCardiac Events (PEACE) studyMyocardial Infarction StudyMyocardial infarction patientsSpecific health statusHigher crude ratesSex differencesCardiovascular deathMultivariable analysisInfarction patientsImplications of coronary artery calcium testing on risk stratification for lipid-lowering therapy according to the 2016 European Society of Cardiology recommendations: The MESA study
Bittencourt MS, Blankstein R, Blaha MJ, Sandfort V, Agatston AS, Budoff MJ, Blumenthal RS, Krumholz HM, Nasir K. Implications of coronary artery calcium testing on risk stratification for lipid-lowering therapy according to the 2016 European Society of Cardiology recommendations: The MESA study. European Journal Of Preventive Cardiology 2018, 25: 1887-1898. PMID: 30043629, DOI: 10.1177/2047487318788930.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBiomarkersClinical Decision-MakingCoronary AngiographyCoronary Artery DiseaseDyslipidemiasFemaleHumansHypolipidemic AgentsIncidenceLipidsMaleMiddle AgedPractice Guidelines as TopicPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsUnited StatesVascular CalcificationConceptsLipid-lowering treatmentCoronary artery calciumLipid-lowering therapyArtery calciumHigher cardiovascular mortalityCardiovascular mortalityUncontrolled groupCoronary Artery Calcium TestingCoronary heart disease eventsEuropean SocietyHeart disease eventsCardiovascular mortality ratesCardiovascular risk assessmentLow-risk groupCardiology recommendationsCardiology guidelinesCardiovascular riskESC recommendationsRisk stratificationMESA participantsCalcium testingRisk groupsGroup 31Lower incidenceMESA studySex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study
Lu Y, Ding Q, Xu X, Spatz ES, Dreyer RP, D'Onofrio G, Caulfield M, Nasir K, Spertus JA, Krumholz HM. Sex Differences in Omega‐3 and ‐6 Fatty Acids and Health Status Among Young Adults With Acute Myocardial Infarction: Results From the VIRGO Study. Journal Of The American Heart Association 2018, 7: e008189. PMID: 29848494, PMCID: PMC6015388, DOI: 10.1161/jaha.117.008189.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHealth status scoresArachidonic acidVIRGO StudyStatus scoreMyocardial infarctionHealth statusPoorer health status outcomesYoung menPatient-reported health statusYoung womenOmega-3 fatty acidsSex differencesPatient-reported outcomesFatty acidsHealth status outcomesCardiovascular outcomesClinical characteristicsAdjusted analysisAMI patientsRisk factorsUS adultsStatus outcomesOmega-3Women 1Comparison of Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors in China and the United States
Lu Y, Wang P, Zhou T, Lu J, Spatz ES, Nasir K, Jiang L, Krumholz HM. Comparison of Prevalence, Awareness, Treatment, and Control of Cardiovascular Risk Factors in China and the United States. Journal Of The American Heart Association 2018, 7: e007462. PMID: 29374046, PMCID: PMC5850247, DOI: 10.1161/jaha.117.007462.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntihypertensive AgentsAttitude of Health PersonnelBlood GlucoseBlood PressureBody Mass IndexCardiovascular DiseasesChinaDiabetes MellitusDyslipidemiasFemaleHealth Knowledge, Attitudes, PracticeHealth Status DisparitiesHumansHypertensionHypolipidemic AgentsLipidsLongitudinal StudiesMaleMiddle AgedNutrition SurveysObesityPractice Patterns, Physicians'PrevalencePrognosisRisk AssessmentRisk FactorsTime FactorsUnited StatesWaist CircumferenceConceptsHigher stroke prevalenceCardiovascular risk factorsHigh-sensitivity C-reactive proteinBody mass indexC-reactive proteinRisk factorsBlood pressureWaist circumferenceMass indexStroke prevalenceCardiovascular risk factor profileHigher mean blood pressureControl of hypertensionMean blood pressureBlood pressure levelsRisk factor profileComparison of prevalenceRepresentative population sampleLower ratesDyslipidemia awarenessSevere hypertensionHemoglobin A1cHypertension treatmentControl ratePlasma glucose
2017
Comparison of Electrocardiographic Characteristics in Men Versus Women ≤ 55 Years With Acute Myocardial Infarction (a Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients Substudy)
Barrabés JA, Gupta A, Porta-Sánchez A, Strait KM, Acosta-Vélez JG, D'Onofrio G, Lidón RM, Geda M, Dreyer RP, Lorenze NP, Lichtman JH, Spertus JA, Bueno H, Krumholz HM. Comparison of Electrocardiographic Characteristics in Men Versus Women ≤ 55 Years With Acute Myocardial Infarction (a Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients Substudy). The American Journal Of Cardiology 2017, 120: 1727-1733. PMID: 28865896, DOI: 10.1016/j.amjcard.2017.07.106.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionST-segment depressionElectrocardiographic presentationMyocardial infarctionQ wavesAnterior ST segment depressionST-segment elevation myocardial infarction diagnosisOutcome of AMIYoung AMI patientsMen Versus WomenST-segment elevationLonger QTc intervalsIntraventricular conduction disturbancesCentral core labNegative T wavesAbnormal Q wavesGender-related differencesBaseline characteristicsContemporary registryAnterior leadsMyocardial infarction diagnosisYounger patientsQTc intervalAMI patientsWorse prognosisWith Great Power Comes Great Responsibility
Khera R, Krumholz HM. With Great Power Comes Great Responsibility. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003846. PMID: 28705865, PMCID: PMC5728376, DOI: 10.1161/circoutcomes.117.003846.Peer-Reviewed Original Research
2016
Editor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis
Bucholz EM, Strait KM, Dreyer RP, Lindau ST, D’Onofrio G, Geda M, Spatz ES, Beltrame JF, Lichtman JH, Lorenze NP, Bueno H, Krumholz HM. Editor’s Choice-Sex differences in young patients with acute myocardial infarction: A VIRGO study analysis. European Heart Journal Acute Cardiovascular Care 2016, 6: 610-622. PMID: 27485141, PMCID: PMC5459677, DOI: 10.1177/2048872616661847.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionYoung womenTime of AMIST-segment elevation myocardial infarctionHigh clinical risk scoreSegment elevation myocardial infarctionChronic obstructive pulmonary diseaseYoung AMI patientsCardiovascular risk factorsClinical risk scorePre-hospital delayProspective cohort studyCongestive heart failureElevation myocardial infarctionObstructive pulmonary diseaseHigh-risk populationYoung menMental health statusElectrocardiogram findingsMorbid obesityCardiovascular riskCohort studyRenal failureYounger patientsAssociation 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