2022
Institutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation
Ngo L, Ali A, Ganesan A, Woodman R, Krumholz HM, Adams R, Ranasinghe I. Institutional Variation in 30‐Day Complications Following Catheter Ablation of Atrial Fibrillation. Journal Of The American Heart Association 2022, 11: e022009. PMID: 35156395, PMCID: PMC9245833, DOI: 10.1161/jaha.121.022009.Peer-Reviewed Original ResearchConceptsProcedure-related complicationsComplication rateAF ablationAtrial fibrillationCatheter ablationStroke/transient ischemic attackCare qualityTransient ischemic attackRisk of complicationsIschemic attackHospital stayCohort studyCommon complicationHospital dischargePericardial effusionCardiorespiratory failurePrimary outcomeProcedural characteristicsComplicationsPatientsHospitalStudy periodBackground ComplicationsPotential disparitiesFibrillation
2021
Falls in older adults after hospitalization for acute myocardial infarction
Goldstein DW, Hajduk AM, Song X, Tsang S, Geda M, McClurken JB, Tinetti ME, Krumholz HM, Chaudhry SI. Falls in older adults after hospitalization for acute myocardial infarction. Journal Of The American Geriatrics Society 2021, 69: 3476-3485. PMID: 34383963, PMCID: PMC8882265, DOI: 10.1111/jgs.17398.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionSerious fallsOlder patientsMyocardial infarctionRisk factorsAge 75Older adultsMedical record adjudicationLonger hospital stayMonths of dischargeProspective cohort studyMedical record reviewSelf-reported fallsAdults age 75Logistic regression analysisAcademic medical centerHospital stayCohort studyClinical factorsRecord reviewFunctional mobilityNew medicationsFall riskMedical CenterImpaired mobilityTrajectories of Pain After Cardiac Surgery: Implications for Measurement, Reporting, and Individualized Treatment
Mori M, Brooks C, Dhruva SS, Lu Y, Spatz ES, Dey P, Zhang Y, Chaudhry SI, Geirsson A, Allore HG, Krumholz HM. Trajectories of Pain After Cardiac Surgery: Implications for Measurement, Reporting, and Individualized Treatment. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007781. PMID: 34304586, PMCID: PMC8366534, DOI: 10.1161/circoutcomes.120.007781.Peer-Reviewed Original ResearchConceptsPain trajectoriesPain levelsCardiac surgeryHigher painPostoperative painMean pain levelTertiary care centerPostoperative pain experienceTrajectories of painPostoperative day 10Lower median ageGroup-based trajectory modelsModerate decliningHospital stayPain valuesMedian ageStudy cohortMedian lengthCare centerIndividual-level trajectoriesIndividualized treatmentTrajectory classesPainPain experiencePatient experienceIncorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models
Triche EW, Xin X, Stackland S, Purvis D, Harris A, Yu H, Grady JN, Li SX, Bernheim SM, Krumholz HM, Poyer J, Dorsey K. Incorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models. JAMA Network Open 2021, 4: e218512. PMID: 33978722, PMCID: PMC8116982, DOI: 10.1001/jamanetworkopen.2021.8512.Peer-Reviewed Original ResearchConceptsPOA indicatorRisk factorsOutcome measuresQuality outcome measuresRisk-adjustment modelsClaims dataAdmission indicatorsPatient risk factorsAcute myocardial infarctionPatient-level outcomesAdministrative claims dataQuality improvement studyClaims-based measuresComparative effectiveness studiesPatient claims dataInternational Statistical ClassificationMortality outcome measuresRelated Health ProblemsHospital quality measuresRisk model performanceHospital stayIndex admissionCare algorithmHeart failureMortality outcomes
2020
Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study
Arora A, Spatz ES, Herrin J, Riley C, Roy B, Rula EY, Kell KP, Krumholz HM. Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study. BMJ Open 2020, 10: e035645. PMID: 32948545, PMCID: PMC7500307, DOI: 10.1136/bmjopen-2019-035645.Peer-Reviewed Original ResearchConceptsObservational cross-sectional studyCross-sectional studyHigh-poverty countiesMean wellRobert Wood Johnson Foundation County Health RankingsLow physical inactivityPrimary care physiciansCounty characteristicsPopulation health modelCounty Health RankingsPreventable hospital staysHospital stayCare physiciansHighest quartilePhysical inactivityHigh percentageMAIN OUTCOMELow prevalenceIndex scoreHeavy drinkersHealth RankingsPopulation-level measuresHealth modelBottom quintileTop quintile
2019
P415330-Day readmission after hospitalization for heart failure in china
Li J, Bai X, Zhang L, Masoudi F, Spertus J, Krumholz H. P415330-Day readmission after hospitalization for heart failure in china. European Heart Journal 2019, 40: ehz745.0725. DOI: 10.1093/eurheartj/ehz745.0725.Peer-Reviewed Original ResearchDays of dischargeHeart failurePatient characteristicsMedian odds ratioOdds ratioChronic obstructive pulmonary diseaseIndex hospital stayObstructive pulmonary diseaseWeeks of dischargeValvular heart diseaseTransitions of careHF hospitalizationRandom hospitalsCause readmissionEligible patientsHospital stayHospitalization stayReadmission diagnosesReadmission ratesConsecutive patientsHospital readmissionMedian agePulmonary diseasePatient factorsC-statisticTwenty-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
2017
Comparing 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 mortalityHospitalPatient–Provider Communication and Health Outcomes Among Individuals With Atherosclerotic Cardiovascular Disease in the United States
Okunrintemi V, Spatz ES, Di Capua P, Salami JA, Valero-Elizondo J, Warraich H, Virani SS, Blaha MJ, Blankstein R, Butt AA, Borden WB, Dharmarajan K, Ting H, Krumholz HM, Nasir K. Patient–Provider Communication and Health Outcomes Among Individuals With Atherosclerotic Cardiovascular Disease in the United States. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003635. PMID: 28373270, DOI: 10.1161/circoutcomes.117.003635.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAspirinAtherosclerosisCommunicationEmergency Service, HospitalFemaleHealth Care CostsHealth Care SurveysHealth ExpendituresHealth StatusHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLength of StayMaleMental HealthMiddle AgedOdds RatioPatient Reported Outcome MeasuresPatient-Centered CarePhysician-Patient RelationsPlatelet Aggregation InhibitorsQuality Indicators, Health CareRisk FactorsUnited StatesYoung AdultConceptsAtherosclerotic cardiovascular diseasePatient-provider communicationHealthcare resource utilizationPatient-reported outcomesCardiovascular diseaseHealth Plans SurveyMedical Expenditure Panel Survey cohortHigher annual healthcare expendituresRepresentative US adult populationHealthcare expendituresAtherosclerotic cardiovascular disease (ASCVD) patientsConsumer AssessmentEmergency room visitsEvidence-based therapiesAnnual healthcare expendituresCardiovascular disease patientsUS adult populationPlans SurveyMental health statusPatient-centered careOutcomes of interestASA useHospital stayRoom visitsPoor outcome
2015
National Trends in Pulmonary Embolism Hospitalization Rates and Outcomes for Adults Aged ≥65 Years in the United States (1999 to 2010)
Minges KE, Bikdeli B, Wang Y, Kim N, Curtis JP, Desai MM, Krumholz HM. National Trends in Pulmonary Embolism Hospitalization Rates and Outcomes for Adults Aged ≥65 Years in the United States (1999 to 2010). The American Journal Of Cardiology 2015, 116: 1436-1442. PMID: 26409636, PMCID: PMC4841688, DOI: 10.1016/j.amjcard.2015.07.068.Peer-Reviewed Original ResearchConceptsHospitalization ratesMortality rateReadmission ratesBlack patientsPrincipal discharge diagnosis codeOlder adultsCause readmission rateHospital mortality rateProportion of patientsRetrospective cohort studyDischarge diagnosis codesSkilled nursing facilitiesNational trendsSignificant racial differencesHigh rateHome health careHospital stayAdults AgedCohort studyMore patientsTherapeutic advancesDiagnosis codesMedicare feeNursing facilitiesSignificant burden
2014
“Phenotyping” Hospital Value of Care for Patients with Heart Failure
Xu X, Li S, Lin H, Normand S, Kim N, Ott LS, Lagu T, Duan M, Kroch EA, Krumholz HM. “Phenotyping” Hospital Value of Care for Patients with Heart Failure. Health Services Research 2014, 49: 2000-2016. PMID: 24974769, PMCID: PMC4254136, DOI: 10.1111/1475-6773.12197.Peer-Reviewed Original ResearchConceptsLower mortalityHeart failureHeart failure hospitalizationHospital mortality rateLonger hospital stayIntensive care unitDistinct joint trajectoriesValue of careFailure hospitalizationHospital stayCare unitClinical outcomesGroup of hospitalsHospital characteristicsHospital careHospital patternsSurgical proceduresMultinomial logistic regressionMortality rateHigh mortalityHospitalHospitalizationMortalityLogistic regressionHospital ValueST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data
Li J, Li X, Wang Q, Hu S, Wang Y, Masoudi FA, Spertus JA, Krumholz HM, Jiang L, Group F. ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data. The Lancet 2014, 385: 441-451. PMID: 24969506, PMCID: PMC4415374, DOI: 10.1016/s0140-6736(14)60921-1.Peer-Reviewed Original ResearchMeSH KeywordsAgedAspirinChinaClopidogrelFemaleFibrinolytic AgentsHealthcare DisparitiesHospital MortalityHospitals, RuralHospitals, UrbanHumansMaleMiddle AgedMyocardial InfarctionMyocardial ReperfusionPatient AdmissionPercutaneous Coronary InterventionQuality of Health CareRetrospective StudiesTiclopidineTreatment OutcomeConceptsST-segment elevation myocardial infarctionElevation myocardial infarctionHospital mortalityHospital admissionMyocardial infarctionRetrospective analysisPrimary percutaneous coronary interventionAcute myocardial infarction admissionsProportion of patientsUse of aspirinPercutaneous coronary interventionMyocardial infarction admissionsTwo-stage random sampling designQuality of careAnalysis of treatmentBaseline characteristicsCardiac eventsHospital outcomesHospital stayCoronary interventionFamily Planning CommissionClinical profileHospital recordsMedian lengthSTEMI admissions
2013
Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions
Dharmarajan K, Hsieh AF, Lin Z, Bueno H, Ross JS, Horwitz LI, Barreto-Filho JA, Kim N, Suter LG, Bernheim SM, Drye EE, Krumholz HM. Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions. The BMJ 2013, 347: f6571. PMID: 24259033, PMCID: PMC3898430, DOI: 10.1136/bmj.f6571.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionRetrospective cohort studyReadmission diagnosesReadmission ratesHeart failureMyocardial infarctionCohort studySpecific diagnosisReadmission performanceHospital readmission performancePatterns of readmissionDay readmission rateRisk-standardized readmission ratesLow performing hospitalsHospital performanceHigh performing hospitalsReadmission timingDay readmissionHospital stayIndex admissionHospital dischargeReadmission patternsHospital admissionCommon diagnosisMedian timeNational Trends in Heart Failure Hospital Stay Rates, 2001 to 2009
Chen J, Dharmarajan K, Wang Y, Krumholz HM. National Trends in Heart Failure Hospital Stay Rates, 2001 to 2009. Journal Of The American College Of Cardiology 2013, 61: 1078-1088. PMID: 23473413, PMCID: PMC3939721, DOI: 10.1016/j.jacc.2012.11.057.Peer-Reviewed Original ResearchConceptsHospital stay ratesLength of stayHF hospital stayHospital mortalityYears of ageHospital stayPatients 18Stay ratesNational Inpatient Sample dataU.S. hospital dischargesPatients 65 yearsPrimary discharge diagnosisSignificant declineOlder Medicare beneficiariesNational Inpatient SampleBlack menLarge national datasetHospital dischargeOlder patientsPatients 55Younger patientsDischarge diagnosisInpatient SampleMedicare beneficiariesAge 65
2012
Hospital-Level Outcomes Associated with Laparoscopic Colectomy for Cancer in the Minimally Invasive Era
Fox JP, Desai MM, Krumholz HM, Gross CP. Hospital-Level Outcomes Associated with Laparoscopic Colectomy for Cancer in the Minimally Invasive Era. Journal Of Gastrointestinal Surgery 2012, 16: 2112-2119. PMID: 22948842, PMCID: PMC3670114, DOI: 10.1007/s11605-012-2018-z.Peer-Reviewed Original ResearchConceptsLaparoscopy rateLaparoscopic colectomyShorter hospitalizationColon resectionHospital mortalityPostoperative morbidityLow postoperative morbidity rateHigher laparoscopy ratePostoperative morbidity rateRisk-standardized outcomesLow postoperative morbidityShorter hospital stayNationwide Inpatient SampleShort-term outcomesHigher procedure volumeHospital stayComparable morbidityRandomized trialsMorbidity rateInvasive eraInpatient SampleOutcomes AssociatedColectomyMortality rateProcedure volume
2010
Trends in Length of Stay and Short-term Outcomes Among Medicare Patients Hospitalized for Heart Failure, 1993-2006
Bueno H, Ross JS, Wang Y, Chen J, Vidán MT, Normand SL, Curtis JP, Drye EE, Lichtman JH, Keenan PS, Kosiborod M, Krumholz HM. Trends in Length of Stay and Short-term Outcomes Among Medicare Patients Hospitalized for Heart Failure, 1993-2006. JAMA 2010, 303: 2141-2147. PMID: 20516414, PMCID: PMC3020983, DOI: 10.1001/jama.2010.748.Peer-Reviewed Original ResearchConceptsLength of stayShort-term outcomesHeart failureReadmission ratesHospital mortalityDischarge dispositionRisk ratioThirty-day readmission ratesMortality risk ratioSkilled nursing facilitiesHome care servicesHospital stayOlder patientsUnadjusted analysesMedicare patientsObservational studyMedicare feeNursing facilitiesPatientsStayCare servicesMortalityMarked reductionMean lengthOutcomes
2005
Pharmacologic prophylaxis for postoperative atrial tachyarrhythmia in general thoracic surgery: Evidence from randomized clinical trials
Sedrakyan A, Treasure T, Browne J, Krumholz H, Sharpin C, van der Meulen J. Pharmacologic prophylaxis for postoperative atrial tachyarrhythmia in general thoracic surgery: Evidence from randomized clinical trials. Journal Of Thoracic And Cardiovascular Surgery 2005, 129: 997-1005. PMID: 15867772, DOI: 10.1016/j.jtcvs.2004.07.042.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAmiodaroneAnti-Arrhythmia AgentsAtrial FibrillationAtrial FlutterCalcium Channel BlockersDigitalis GlycosidesEvidence-Based MedicineFemaleFlecainideHospital CostsHumansLength of StayMagnesiumMaleMiddle AgedMorbidityPostoperative ComplicationsPremedicationPreoperative CareRandomized Controlled Trials as TopicTachycardia, SupraventricularThoracic Surgical ProceduresTreatment OutcomeConceptsPostoperative atrial tachyarrhythmiasGeneral thoracic surgeryAtrial tachyarrhythmiasCalcium channel blockersRandomized clinical trialsThoracic surgeryClinical trialsSingle small trialLonger hospital stayUse of digitalisPossible adverse eventsFixed-effects modelAntiarrhythmic medicationsPharmacologic prophylaxisHospital stayProphylactic regimenAdverse eventsCommon complicationPulmonary edemaSignificant morbidityUnblinded trialCochrane DatabaseProphylactic useSmall trialsPlacebo control
2002
The prognostic importance of different definitions of worsening renal function in congestive heart failure
Gottlieb SS, Abraham W, Butler J, Forman DE, Loh E, Massie BM, O'Connor CM, Rich MW, Stevenson LW, Young J, Krumholz HM. The prognostic importance of different definitions of worsening renal function in congestive heart failure. Journal Of Cardiac Failure 2002, 8: 136-141. PMID: 12140805, DOI: 10.1054/jcaf.2002.125289.Peer-Reviewed Original ResearchConceptsCongestive heart failureRenal functionLength of stayHeart failurePrognostic importanceDepressed ejection fractionProlonged hospital stayFinal creatinineHospital mortalityHospital stayRenal failureSerum creatinineDL increaseEjection fractionACE inhibitorsPoor prognosisPatient populationWorse outcomesPrior historyTherapeutic interventionsCreatinineStayPatientsMortalityDl
1999
Variations in and correlates of length of stay in academic hospitals among patients with heart failure resulting from systolic dysfunction.
Krumholz HM, Chen YT, Bradford WD, Cerese J. Variations in and correlates of length of stay in academic hospitals among patients with heart failure resulting from systolic dysfunction. The American Journal Of Managed Care 1999, 5: 715-23. PMID: 10538451.Peer-Reviewed Original ResearchConceptsLength of stayCongestive heart failureHeart failureSystolic dysfunctionPatient characteristicsAcademic hospitalCollaborative quality improvement projectIndividual hospitalsAdmission clinical characteristicsRetrospective cohort studyPrincipal discharge diagnosisNumber of patientsQuality improvement projectUniversity HealthSystem ConsortiumCorrelates of lengthHospital stayPeripheral edemaClinical characteristicsCohort studyRenal failureClinical factorsMajor complicationsHospital eventsRegression modelsAtrial fibrillation
1995
Outcomes after major vascular surgery: The patients' perspective
Lacey K, Meier G, Krumholz H, Gusberg R. Outcomes after major vascular surgery: The patients' perspective. Journal Of Vascular Nursing 1995, 13: 8-13. PMID: 7742256, DOI: 10.1016/s1062-0303(05)80047-0.Peer-Reviewed Original ResearchConceptsQuality of lifeLong-term survivorsElderly patientsSF-36Surgical outcomesYale-New Haven HospitalBilateral renal revascularizationMinimal physical disabilityMajor vascular surgeryOutcome of surgeryVascular surgical interventionGroup of patientsHealth Status QuestionnaireIntensive care unitLong-term resultsRates of morbidityHigh-risk interventionsTraditional outcome measuresAssessment of outcomesRenal revascularizationVascular nurseHospital stayOperative morbidityPostoperative qualityCare unit