2024
Social Determinants of Health and Delivery of Rehabilitation to Older Adults During ICU Hospitalization
Jain S, Murphy T, Falvey J, Leo-Summers L, O’Leary J, Zang E, Gill T, Krumholz H, Ferrante L. Social Determinants of Health and Delivery of Rehabilitation to Older Adults During ICU Hospitalization. JAMA Network Open 2024, 7: e2410713. PMID: 38728030, PMCID: PMC11087837, DOI: 10.1001/jamanetworkopen.2024.10713.Peer-Reviewed Original ResearchConceptsSocial determinants of healthDeterminants of healthOccupational therapyPhysical therapyOlder adultsRural residentsIntensive care unit hospitalizationRehabilitation deliveryIntensive care unitSocial determinantsSocioeconomic disadvantageNational Health and Aging Trends StudyDelivery of physical therapyIllness hospitalizationFactors associated with lower oddsDelivery of rehabilitationIn-hospital rehabilitationMitigate functional declineMedicaid eligibilityBurden of disabilityHigh school educationDual MedicareTrends StudyMedicare claimsLength of stay
2023
Impact of Sex‐ and Gender‐Related Factors on Length of Stay Following Non–ST‐Segment–Elevation Myocardial Infarction: A Multicountry Analysis
Bender U, Norris C, Dreyer R, Krumholz H, Raparelli V, Pilote L. Impact of Sex‐ and Gender‐Related Factors on Length of Stay Following Non–ST‐Segment–Elevation Myocardial Infarction: A Multicountry Analysis. Journal Of The American Heart Association 2023, 12: e028553. PMID: 37489737, PMCID: PMC10492965, DOI: 10.1161/jaha.122.028553.Peer-Reviewed Original ResearchConceptsSegment elevation myocardial infarctionMyocardial infarctionGender-related factorsLonger LOSSegment elevation myocardial infarction diagnosisConclusions Older ageObservational cohort studyAdverse clinical outcomesAdjusted multivariable modelAcute myocardial infarctionLength of stayImpact of sexHealth care expendituresGENESIS-PRAXYHospital lengthNon–STCause mortalityCohort studyIndependent predictorsMyocardial infarction diagnosisClinical outcomesShorter LOSMedical historyMultivariable modelUnivariate associations
2021
180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study
Dodson JA, Hajduk AM, Murphy TE, Geda M, Krumholz HM, Tsang S, Nanna MG, Tinetti ME, Ouellet G, Sybrant D, Gill TM, Chaudhry SI. 180-day readmission risk model for older adults with acute myocardial infarction: the SILVER-AMI study. Open Heart 2021, 8: e001442. PMID: 33452007, PMCID: PMC7813425, DOI: 10.1136/openhrt-2020-001442.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionReadmission risk modelSelf-reported health statusMyocardial infarctionFunctional mobilityOlder adultsHealth statusDays of AMIFirst diastolic blood pressureChronic obstructive pulmonary diseaseIschemic ECG changesProspective cohort studyDiastolic blood pressureObstructive pulmonary diseaseLength of stayInitial heart rateFinal risk modelSILVER-AMI StudyRisk modelInitial hemoglobinCohort studyReadmission ratesBlood pressureEjection fractionHeart failure
2017
Trends in acute pericarditis hospitalizations and outcomes among the elderly in the USA, 1999–2012
Mody P, Bikdeli B, Wang Y, Imazio M, Krumholz HM. Trends in acute pericarditis hospitalizations and outcomes among the elderly in the USA, 1999–2012. European Heart Journal - Quality Of Care And Clinical Outcomes 2017, 4: 98-105. PMID: 29106473, PMCID: PMC6279101, DOI: 10.1093/ehjqcco/qcx040.Peer-Reviewed Original ResearchConceptsLength of stayHospitalization ratesMortality rateReadmission ratesStudy periodCause readmission rateCause mortality ratesLong-term outcomesPrincipal discharge diagnosisRisk of pericarditisHealth care expendituresAcute pericarditisCardiac surgeryRenal diseaseDischarge diagnosisPericarditisHigh riskMedicare beneficiariesHospitalizationOlder adultsCare expendituresStayOutcomesRiskCauseNational 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 catheterComparing 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
2015
National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010
Dodson JA, Wang Y, Murugiah K, Dharmarajan K, Cooper Z, Hashim S, Nuti SV, Spatz E, Desai N, Krumholz HM. National Trends in Hospital Readmission Rates among Medicare Fee-for-Service Survivors of Mitral Valve Surgery, 1999–2010. PLOS ONE 2015, 10: e0132470. PMID: 26147225, PMCID: PMC4493110, DOI: 10.1371/journal.pone.0132470.Peer-Reviewed Original ResearchConceptsMitral valve surgeryLength of stayHospital LOSReadmission ratesHospital readmission ratesOlder patientsHospital readmissionMedicare feeMean hospital LOSSurvival rateProportional hazards regressionYears of ageValve surgeryHazards regressionService patientsWorse outcomesAge subgroupsPatientsOlder adultsSurvivorsNational trendsReadmissionModest declineWomenSubgroups
2014
Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010
Gupta A, Wang Y, Spertus JA, Geda M, Lorenze N, Nkonde-Price C, D'Onofrio G, Lichtman JH, Krumholz HM. Trends in Acute Myocardial Infarction in Young Patients and Differences by Sex and Race, 2001 to 2010. Journal Of The American College Of Cardiology 2014, 64: 337-345. PMID: 25060366, PMCID: PMC4415523, DOI: 10.1016/j.jacc.2014.04.054.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionLength of stayHospital mortalityHospitalization ratesClinical characteristicsAge groupsAMI hospitalization ratesYounger patientsMyocardial infarctionLonger LOSNationwide Inpatient Sample dataYoung womenU.S. hospital dischargesPrevalence of comorbiditiesPrincipal discharge diagnosisNational Inpatient SampleSex differencesContemporary longitudinal dataLarge national datasetMore comorbiditiesHospital dischargeDischarge diagnosisInpatient SampleMortality rateAge 30Transfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction
Barreto-Filho JA, Wang Y, Rathore SS, Spatz ES, Ross JS, Curtis JP, Nallamothu BK, Normand SL, Krumholz HM. Transfer Rates From Nonprocedure Hospitals After Initial Admission and Outcomes Among Elderly Patients With Acute Myocardial Infarction. JAMA Internal Medicine 2014, 174: 213-222. PMID: 24296747, DOI: 10.1001/jamainternmed.2013.11944.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionCoronary artery bypass graft surgeryArtery bypass graft surgeryRisk-standardized mortality ratesBypass graft surgeryPercutaneous coronary interventionLength of stayMyocardial infarctionElderly patientsGraft surgeryRevascularization ratesCoronary interventionMortality rateLower risk-standardized mortality ratesRate of catheterizationHospital transfer ratesInvasive cardiac proceduresTransfer of patientsRisk-standardized mortalityHospital outcomesInitial admissionMedian lengthService patientsCardiac proceduresHospital differences
2013
National 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 Patterns of Use of Positive Inotropic Agents in Patients With Heart Failure
Partovian C, Gleim SR, Mody PS, Li SX, Wang H, Strait KM, Allen LA, Lagu T, Normand SL, Krumholz HM. Hospital Patterns of Use of Positive Inotropic Agents in Patients With Heart Failure. Journal Of The American College Of Cardiology 2012, 60: 1402-1409. PMID: 22981548, PMCID: PMC3636773, DOI: 10.1016/j.jacc.2012.07.011.Peer-Reviewed Original ResearchConceptsPositive inotropic agentsRisk-standardized ratesInotropic agentsHeart failureInotrope useHospital patternsMortality rateRisk-standardized mortality ratesHospital mortality rateHeart failure patientsLittle clinical evidenceLength of stayPatient case mixHierarchical logistic regression modelsLogistic regression modelsIntraclass correlation coefficientFailure patientsHospital variationClinical evidenceInterhospital variationClinical guidelinesIndividual hospital effectsHospital ratesHospital effectsPatterns of useProcedure 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 use
2011
30-Day Readmission for Patients Undergoing Percutaneous Coronary Interventions in New York State
Hannan EL, Zhong Y, Krumholz H, Walford G, Holmes DR, Stamato NJ, Jacobs AK, Venditti FJ, Sharma S, King SB. 30-Day Readmission for Patients Undergoing Percutaneous Coronary Interventions in New York State. JACC Cardiovascular Interventions 2011, 4: 1335-1342. PMID: 22192374, DOI: 10.1016/j.jcin.2011.08.013.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionReadmission ratesUnique risk factorsRisk factorsCoronary interventionAdministrative databasesComplications of PCIPre-procedural risk factorsRepeat percutaneous coronary interventionChronic ischemic heart diseaseOverall readmission rateHigher readmission ratesIschemic heart diseaseLength of stayNew York State patientsRecognition of patientsDiagnostic risk factorsCost-effectiveness standpointPCI patientsPCI registryChest painHeart failureHospital readmissionHeart diseasePrincipal diagnosisFactors Associated With 30-Day Readmission Rates After Percutaneous Coronary Intervention
Khawaja FJ, Shah ND, Lennon RJ, Slusser JP, Alkatib AA, Rihal CS, Gersh BJ, Montori VM, Holmes DR, Bell MR, Curtis JP, Krumholz HM, Ting HH. Factors Associated With 30-Day Readmission Rates After Percutaneous Coronary Intervention. JAMA Internal Medicine 2011, 172: 112-117. PMID: 22123752, PMCID: PMC3688066, DOI: 10.1001/archinternmed.2011.569.Peer-Reviewed Original ResearchMeSH KeywordsAcute Coronary SyndromeAgedAngina, UnstableAngioplasty, Balloon, CoronaryCoronary Artery BypassEducational StatusFemaleFollow-Up StudiesHeart FailureHumansIschemic Attack, TransientKidney DiseasesLength of StayMaleMedicareMultivariate AnalysisMyocardial InfarctionNeoplasm MetastasisPatient ReadmissionPeptic UlcerProportional Hazards ModelsPulmonary Disease, Chronic ObstructiveRegistriesSex FactorsStrokeUnited StatesConceptsPercutaneous coronary interventionThirty-day readmissionReadmission ratesCoronary interventionHigh riskChronic obstructive pulmonary diseaseThirty-day readmission ratesCox proportional hazards modelMultivariate logistic regression modelTransient ischemic attackCongestive heart failureObstructive pulmonary diseasePeptic ulcer diseaseSevere renal diseaseAcute myocardial infarctionLength of stayMain outcome measuresProportional hazards modelSaint Mary's HospitalLogistic regression modelsIschemic attackTime-dependent covariatesUnstable anginaCerebrovascular accidentHeart failure
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
2007
Temporal Trends of Outcomes for Nonagenarians Undergoing Coronary Artery Bypass Grafting, 1993 to 1999
Lichtman JH, Kapoor R, Wang Y, Radford MJ, Allen NB, Krumholz HM. Temporal Trends of Outcomes for Nonagenarians Undergoing Coronary Artery Bypass Grafting, 1993 to 1999. The American Journal Of Cardiology 2007, 100: 1630-1634. PMID: 18036360, DOI: 10.1016/j.amjcard.2007.06.067.Peer-Reviewed Original ResearchConceptsCABG proceduresMortality outcomesMortality rateLong-term mortality outcomesShort-term mortality outcomesOverall crude mortality rateService Medicare patientsCoronary artery bypassLength of stayCrude mortality rateService Medicare beneficiariesSkilled nursing facilitiesHigh mortality rateProjected life expectancyNumber of proceduresArtery bypassDischarge dispositionMedicare patientsMedicare beneficiariesNursing facilitiesNonagenariansMean lengthTemporal trendsLife expectancyWomenChanges in outcomes for internal medicine inpatients after work-hour regulations.
Horwitz LI, Kosiborod M, Lin Z, Krumholz HM. Changes in outcomes for internal medicine inpatients after work-hour regulations. Annals Of Internal Medicine 2007, 147: 97-103. PMID: 17548401, DOI: 10.7326/0003-4819-147-2-200707170-00163.Peer-Reviewed Original ResearchConceptsIntensive care unit utilizationLength of stayDrug-drug interactionsWork-hour regulationsNonteaching servicesHospital deathPharmacist interventionsReadmission ratesConsecutive patientsRetrospective cohort studyInternal medicine patientsInternal medicine inpatientsUnit utilizationAdverse drug-drug interactionsTeaching serviceAcademic medical centerCohort studyDischarge dispositionMedicine inpatientsMedicine patientsFatigue-related errorsMedical CenterRehabilitation facilityRate of dischargePatients
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
Use of critical pathways to improve the care of patients with acute myocardial infarction11Dr. Krumholz is a Paul Beeson Faculty Scholar. This article was written by CDR Eric S. Holmboe while a fellow in the Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.
Holmboe E, Meehan T, Radford M, Wang Y, Marciniak T, Krumholz H. Use of critical pathways to improve the care of patients with acute myocardial infarction11Dr. Krumholz is a Paul Beeson Faculty Scholar. This article was written by CDR Eric S. Holmboe while a fellow in the Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government. The American Journal Of Medicine 1999, 107: 324-331. PMID: 10527033, DOI: 10.1016/s0002-9343(99)00239-9.Peer-Reviewed Original ResearchConceptsLength of stayEvidence-based medical therapyProportion of patientsMyocardial infarctionMedical therapyMedicare patientsMain endpointCritical pathwaysAngiotensin-converting enzyme inhibitorAcute myocardial infarctionCare of patientsLongitudinal cohort studyProcess of careFirst dayQuality of careCross-sectional analysisReperfusion therapyCohort studyPrincipal diagnosisConnecticut hospitalsPatientsEnzyme inhibitorsYale University SchoolStayClinical Scholars ProgramVariations 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