2022
Trends in Adverse Event Rates in Hospitalized Patients, 2010-2019
Eldridge N, Wang Y, Metersky M, Eckenrode S, Mathew J, Sonnenfeld N, Perdue-Puli J, Hunt D, Brady PJ, McGann P, Grace E, Rodrick D, Drye E, Krumholz HM. Trends in Adverse Event Rates in Hospitalized Patients, 2010-2019. JAMA 2022, 328: 173-183. PMID: 35819424, PMCID: PMC9277501, DOI: 10.1001/jama.2022.9600.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAdultAgedAged, 80 and overCross InfectionCross-Sectional StudiesDrug-Related Side Effects and Adverse ReactionsFemaleHeart FailureHospitalizationHumansMaleMedicareMiddle AgedMyocardial InfarctionPatient SafetyPneumoniaPostoperative ComplicationsPressure UlcerRisk AssessmentSurgical Procedures, OperativeUnited StatesConceptsMajor surgical proceduresAcute myocardial infarctionAdverse event ratesGeneral adverse eventsAdverse eventsHeart failureAdverse drug eventsAcute care hospitalsMyocardial infarctionHospital-acquired infectionsSurgical proceduresEvent ratesHospital dischargeCare hospitalDrug eventsMedicare Patient Safety Monitoring SystemSerial cross-sectional studyPatient safetyUS acute care hospitalsHospital adverse eventsSignificant decreaseSurgical procedure groupsCross-sectional studyRisk-adjusted ratesAdult patientsInstitutional 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 ResearchMeSH KeywordsAdolescentAgedAtrial FibrillationCatheter AblationCohort StudiesFemaleHumansMaleMiddle AgedPatient DischargePostoperative ComplicationsRisk FactorsTreatment OutcomeConceptsProcedure-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
Toward Dynamic Risk Prediction of Outcomes After Coronary Artery Bypass Graft
Mori M, Durant TJS, Huang C, Mortazavi BJ, Coppi A, Jean RA, Geirsson A, Schulz WL, Krumholz HM. Toward Dynamic Risk Prediction of Outcomes After Coronary Artery Bypass Graft. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007363. PMID: 34078100, PMCID: PMC8635167, DOI: 10.1161/circoutcomes.120.007363.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCardiac Surgical ProceduresCoronary Artery BypassFemaleHumansLogistic ModelsPostoperative ComplicationsRisk AssessmentRisk FactorsConceptsCoronary artery bypass graftArtery bypass graftIntraoperative variablesBypass graftLogistic regression modelsOperative mortalityC-statisticCoronary artery bypass graft casesThoracic Surgeons Adult Cardiac Surgery DatabaseAdult Cardiac Surgery DatabaseMean patient ageGood c-statisticCardiac Surgery DatabaseBrier scoreRisk restratificationDynamic risk predictionIntraoperative deathsPostoperative complicationsPostoperative eventsAdverse eventsPatient agePreoperative variablesRegression modelsGraft casesSurgery Database
2020
Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults
Mori M, Wang Y, Mahajan S, Geirsson A, Krumholz HM. Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults. JAMA Network Open 2020, 3: e2031078. PMID: 33355673, PMCID: PMC7758803, DOI: 10.1001/jamanetworkopen.2020.31078.Peer-Reviewed Original ResearchConceptsSurgical aortic valve replacementElective surgical aortic valve replacementAortic valve replacementValve replacementReadmission riskCoronary artery bypass graft surgeryArtery bypass graft surgeryOlder adultsBypass graft surgeryCoronary artery bypassCross-sectional studyArtery bypassGraft surgeryInfluenza seasonMedicaid ServicesMortalitySeverityAdultsRiskAssociationSurgeryBypassProtocol for project recovery after cardiac surgery: a single-center cohort study leveraging digital platform to characterise longitudinal patient-reported postoperative recovery patterns
Mori M, Brooks C, Spatz E, Mortazavi BJ, Dhruva SS, Linderman GC, Grab LA, Zhang Y, Geirsson A, Chaudhry SI, Krumholz HM. Protocol for project recovery after cardiac surgery: a single-center cohort study leveraging digital platform to characterise longitudinal patient-reported postoperative recovery patterns. BMJ Open 2020, 10: e036959. PMID: 32873671, PMCID: PMC7467526, DOI: 10.1136/bmjopen-2020-036959.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresCohort StudiesHumansPatient Reported Outcome MeasuresPostoperative ComplicationsProspective StudiesConceptsPatient-reported outcome measuresCohort studyHospital dischargeCardiac surgerySingle-center cohort studyCoronary artery bypass graftIntensive care unit dischargeMedical record review dataPostoperative patient recoveryPostoperative recovery patternsArtery bypass graftProspective cohort studyGroup-based trajectory modellingMedical record reviewRecovery patternsRecord review dataHealth information exchange platformInstitutional review boardAortic surgeryHospital coursePatient demographicsPeer-reviewed journalsClinical factorsHospital readmissionOperative details
2018
Percutaneous Coronary Intervention in Patients Without Acute Myocardial Infarction in China
Lu Y, Zhang H, Wang Y, Zhou T, Welsh J, Liu J, Guan W, Li J, Li X, Zheng X, Spertus JA, Masoudi FA, Krumholz HM, Jiang L. Percutaneous Coronary Intervention in Patients Without Acute Myocardial Infarction in China. JAMA Network Open 2018, 1: e185446. PMID: 30646292, PMCID: PMC6324328, DOI: 10.1001/jamanetworkopen.2018.5446.Peer-Reviewed Original ResearchConceptsStable coronary artery diseaseAcute myocardial infarctionCoronary artery diseaseSeattle Angina QuestionnairePercutaneous coronary interventionClinical improvementSmall clinical improvementAngina symptomsUnstable anginaArtery diseaseHealth statusCoronary interventionSymptom burdenMyocardial infarctionSAQ scoresSAQ angina frequency scorePatient-reported health statusPercutaneous coronary intervention (PCI) proceduresSelf-reported health statusAngina frequency scoreMulticenter cohort studyGreater clinical improvementSubstantial clinical improvementIschemic heart diseaseCoronary intervention proceduresIs Posthospital Syndrome a Result of Hospitalization-Induced Allostatic Overload?
Goldwater DS, Dharmarajan K, McEwan BS, Krumholz HM. Is Posthospital Syndrome a Result of Hospitalization-Induced Allostatic Overload? Journal Of Hospital Medicine 2018, 13 PMID: 29813141, DOI: 10.12788/jhm.2986.Peer-Reviewed Original ResearchMeSH KeywordsAllostasisBiomarkersHospitalizationHumansHydrocortisoneHypothalamo-Hypophyseal SystemPatient ReadmissionPituitary-Adrenal SystemPostoperative ComplicationsStress, PsychologicalSyndromeConceptsPosthospital syndromeAllostatic overloadAutonomic nervous systemMultiple organ systemsHospital dischargeInflammatory markersAdverse eventsHospital readmissionAdrenal axisAdverse outcomesPlausible etiologyPathophysiologic consequencesElevated riskNervous systemNarrative reviewOrgan systemsEnhanced vulnerabilityElevated levelsHospital environmentTraditional hospital environmentSyndromeMaladaptive statesOverloadOutcomesPossible mechanism
2017
Trends 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 modelsPrediction of Adverse Events in Patients Undergoing Major Cardiovascular Procedures
Mortazavi B, Desai N, Zhang J, Coppi A, Warner F, Krumholz H, Negahban S. Prediction of Adverse Events in Patients Undergoing Major Cardiovascular Procedures. IEEE Journal Of Biomedical And Health Informatics 2017, 21: 1719-1729. PMID: 28287993, DOI: 10.1109/jbhi.2017.2675340.Peer-Reviewed Original ResearchMeSH KeywordsCardiac Surgical ProceduresElectronic Health RecordsHumansMachine LearningModels, StatisticalPostoperative ComplicationsConceptsMajor cardiovascular proceduresElectronic health recordsRespiratory failureAdverse eventsCardiovascular proceduresYale-New Haven HospitalPostoperative respiratory failurePatient cohortHospital costsPatient outcomesSpecific patientPatientsHealth recordsCohort-specific modelsCharacteristic curveInfectionFailureHospitalCohortClinicians
2016
Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study
Zheng X, Curtis JP, Hu S, Wang Y, Yang Y, Masoudi FA, Spertus JA, Li X, Li J, Dharmarajan K, Downing NS, Krumholz HM, Jiang L. Coronary Catheterization and Percutaneous Coronary Intervention in China: 10-Year Results From the China PEACE-Retrospective CathPCI Study. JAMA Internal Medicine 2016, 176: 512. PMID: 26974883, PMCID: PMC5459379, DOI: 10.1001/jamainternmed.2016.0166.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngina, UnstableCardiac CatheterizationChinaCoronary Artery DiseaseDrug-Eluting StentsFemaleHospital MortalityHospitals, UrbanHumansLength of StayMaleMedical RecordsMiddle AgedMyocardial InfarctionOdds RatioOutcome Assessment, Health CarePercutaneous Coronary InterventionPostoperative ComplicationsPostoperative HemorrhageQuality of Health CareRetrospective StudiesStentsTime-to-TreatmentConceptsPercutaneous coronary interventionDrug-eluting stentsQuality of careCoronary catheterizationCoronary interventionNonobstructive coronary artery diseasePrimary percutaneous coronary interventionFuture quality improvement initiativesEvidence-based medicationsOutcomes of patientsCoronary artery diseaseClinical observational studyUse of catheterizationQuality improvement initiativesCalendar year 2001Hospital mortalityArtery diseasePatient characteristicsStable patientsTreatment patternsMedian lengthMean agePCI proceduresMedical recordsObservational study
2015
Patients need safer hospitals, every day of the week
Dharmarajan K, Kim N, Krumholz HM. Patients need safer hospitals, every day of the week. The BMJ 2015, 350: h1826. PMID: 25877669, DOI: 10.1136/bmj.h1826.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHospitalizationHumansIatrogenic DiseaseMaleMedical ErrorsPostoperative Complications
2014
Trends in Hospitalizations Among Medicare Survivors of Aortic Valve Replacement in the United States From 1999 to 2010
Murugiah K, Wang Y, Dodson JA, Nuti SV, Dharmarajan K, Ranasinghe I, Cooper Z, Krumholz HM. Trends in Hospitalizations Among Medicare Survivors of Aortic Valve Replacement in the United States From 1999 to 2010. The Annals Of Thoracic Surgery 2014, 99: 509-517. PMID: 25527425, PMCID: PMC4454375, DOI: 10.1016/j.athoracsur.2014.08.045.Peer-Reviewed Original ResearchMeSH KeywordsAgedAortic ValveFemaleHeart Valve Prosthesis ImplantationHospitalizationHumansMaleMedicarePostoperative ComplicationsSurvivorsTime FactorsUnited StatesConceptsAortic valve replacementValve replacementHospitalization ratesAnnual Medicare paymentsPrincipal diagnosisOne-year hospitalization rateCommon principal diagnosisRisk of hospitalizationMean lengthGeneral Medicare populationMedicare paymentsPostoperative complicationsHeart failureBlack patientsMedicare patientsHospitalizationMedicare populationMedicare beneficiariesMortality ratePatientsStayCumulative daysCumulative lengthCertain subgroupsSurvivorsVariation in Hospital-Level Risk-Standardized Complication Rates Following Elective Primary Total Hip and Knee Arthroplasty
Bozic KJ, Grosso LM, Lin Z, Parzynski CS, Suter LG, Krumholz HM, Lieberman JR, Berry DJ, Bucholz R, Han L, Rapp MT, Bernheim S, Drye EE. Variation in Hospital-Level Risk-Standardized Complication Rates Following Elective Primary Total Hip and Knee Arthroplasty. Journal Of Bone And Joint Surgery 2014, 96: 640-647. PMID: 24740660, DOI: 10.2106/jbjs.l.01639.Peer-Reviewed Original ResearchConceptsElective total hip arthroplastyTotal hip arthroplastyComplication rateBlack patientsStudy cohortTKA proceduresMedicaid patientsU.S. hospitalsMedicare feeElective primary total hip arthroplastyPrimary total hip arthroplastyElective primary total hipTotal knee arthroplasty proceduresPrimary total hipPeriprosthetic joint infectionKnee arthroplasty proceduresNational Medicare feeHigher proportionHospital-level riskNational Quality ForumCross-sectional analysisHierarchical logistic regressionTKA patientsCommon complicationPatient comorbiditiesNational Trends in Patient Safety for Four Common Conditions, 2005–2011
Wang Y, Eldridge N, Metersky ML, Verzier NR, Meehan TP, Pandolfi MM, Foody JM, Ho SY, Galusha D, Kliman RE, Sonnenfeld N, Krumholz HM, Battles J. National Trends in Patient Safety for Four Common Conditions, 2005–2011. New England Journal Of Medicine 2014, 370: 341-351. PMID: 24450892, PMCID: PMC4042316, DOI: 10.1056/nejmsa1300991.Peer-Reviewed Original ResearchConceptsCongestive heart failureAcute myocardial infarctionMore adverse eventsProportion of patientsAdverse event ratesAdverse eventsHeart failureMyocardial infarctionRate of occurrenceCommon medical conditionsMedical recordsMedicare patientsMedical conditionsPatientsSurgeryInfarctionPneumoniaHospitalizationPatient safetyNational trendsMonitoring System dataSignificant declineFailureProportionRate
2013
Hospital-Based, Acute Care Use Among Patients Within 30 Days of Discharge After Coronary Artery Bypass Surgery
Fox JP, Suter LG, Wang K, Wang Y, Krumholz HM, Ross JS. Hospital-Based, Acute Care Use Among Patients Within 30 Days of Discharge After Coronary Artery Bypass Surgery. The Annals Of Thoracic Surgery 2013, 96: 96-104. PMID: 23702228, PMCID: PMC3758868, DOI: 10.1016/j.athoracsur.2013.03.091.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCaliforniaCoronary Artery BypassCoronary Artery DiseaseEmergency Service, HospitalFemaleFollow-Up StudiesHumansIntensive Care UnitsLength of StayLinear ModelsMaleMiddle AgedMorbidityPatient DischargePatient ReadmissionPostoperative ComplicationsPostoperative PeriodPrognosisRecurrenceRetrospective StudiesRisk FactorsSurvival RateTime FactorsYoung AdultConceptsDays of dischargeAcute care needsCABG surgeryED visit ratesED visitsHospital readmissionReadmission ratesCare needsCoronary artery bypass graft surgeryVisit ratesArtery bypass graft surgeryCoronary artery bypass surgeryRisk-standardized readmission ratesAcute care ratesHospital 30 daysBypass graft surgeryAcute care useArtery bypass surgeryCongestive heart failureEmergency department visitsEmergency Department DatabasesChest discomfortGraft surgeryBypass surgeryHospital volume
2012
Preoperative Serum Brain Natriuretic Peptide and Risk of Acute Kidney Injury After Cardiac Surgery
Patel UD, Garg AX, Krumholz HM, Shlipak MG, Coca SG, Sint K, Thiessen-Philbrook H, Koyner JL, Swaminathan M, Passik CS, Parikh CR. Preoperative Serum Brain Natriuretic Peptide and Risk of Acute Kidney Injury After Cardiac Surgery. Circulation 2012, 125: 1347-1355. PMID: 22322531, PMCID: PMC3312808, DOI: 10.1161/circulationaha.111.029686.Peer-Reviewed Original ResearchConceptsSevere acute kidney injuryMild acute kidney injuryAcute kidney injuryPostoperative acute kidney injuryCardiac surgeryPreoperative BNPKidney injuryHigh riskAcute Kidney Injury Network definitionPreoperative brain natriuretic peptide levelsBrain natriuretic peptide levelsSerum brain natriuretic peptideAcute renal replacement therapyAcute Kidney Injury studyDoubling of creatinineHigher AKI riskPreoperative BNP levelsNatriuretic peptide levelsHigh-risk patientsRenal replacement therapyBrain natriuretic peptidePreoperative risk stratificationTypes of patientsAddition of BNPAKI cases
2010
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary
Hiratzka L, Bakris G, Beckman J, Bersin R, Carr V, Casey D, Eagle K, Hermann L, Isselbacher E, Kazerooni E, Kouchoukos N, Lytle B, Milewicz D, Reich D, Sen S, Shinn J, Svensson L, Williams D, Jacobs A, Smith S, Anderson J, Adams C, Buller C, Creager M, Ettinger S, Guyton R, Halperin J, Hunt S, Krumholz H, Kushner F, Lytle B, Nishimura R, Page R, Riegel B, Stevenson W, Tarkington L, Yancy C. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: Executive Summary. Catheterization And Cardiovascular Interventions 2010, 76: e43-e86. PMID: 20687249, DOI: 10.1002/ccd.22537.Peer-Reviewed Original Research
2009
Association of Physician Certification and Outcomes Among Patients Receiving an Implantable Cardioverter-Defibrillator
Curtis JP, Luebbert JJ, Wang Y, Rathore SS, Chen J, Heidenreich PA, Hammill SC, Lampert RI, Krumholz HM. Association of Physician Certification and Outcomes Among Patients Receiving an Implantable Cardioverter-Defibrillator. JAMA 2009, 301: 1661-1670. PMID: 19383957, PMCID: PMC2805129, DOI: 10.1001/jama.2009.547.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiac ElectrophysiologyCertificationClinical CompetenceDefibrillators, ImplantableFemaleHumansIntraoperative ComplicationsLogistic ModelsMaleMedicineMiddle AgedOutcome and Process Assessment, Health CarePhysiciansPostoperative ComplicationsProsthesis ImplantationRegistriesRetrospective StudiesSpecializationTreatment OutcomeUnited StatesConceptsCRT-D devicesThoracic surgeonsICD implantationPhysician certificationImplantable cardioverter-defibrillator (ICD) proceduresRetrospective cohort studyCardiac resynchronization therapyPatients meeting criteriaRisk of complicationsProcedural complication rateImplantable cardioverter defibrillatorHierarchical logistic regression modelsLogistic regression modelsCohort studyComplication rateICD RegistryResynchronization therapyProcedural complicationsIndependent associationPhysician specialtyCardioverter defibrillatorHigh riskPatientsMeeting criteriaNonelectrophysiologists
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 ResearchMeSH KeywordsAge FactorsAged, 80 and overCoronary Artery BypassFemaleHospital MortalityHumansLength of StayMalePostoperative ComplicationsSurvival RateTreatment OutcomeConceptsCABG 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 expectancyWomen
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