2018
Is 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 ResearchConceptsPosthospital 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
Risk Trajectories of Readmission and Death in the First Year after Hospitalization for Chronic Obstructive Pulmonary Disease
Lindenauer PK, Dharmarajan K, Qin L, Lin Z, Gershon AS, Krumholz HM. Risk Trajectories of Readmission and Death in the First Year after Hospitalization for Chronic Obstructive Pulmonary Disease. American Journal Of Respiratory And Critical Care Medicine 2017, 197: 1009-1017. PMID: 29206052, PMCID: PMC5909167, DOI: 10.1164/rccm.201709-1852oc.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseSame respective groupsObstructive pulmonary diseaseVentilator supportPulmonary diseaseRisk of readmissionRisk of hospitalizationGeneral elderly populationGeneral Medicare populationRisk of deathDaily riskRespective groupsReadmission ratesHospital readmissionAbsolute riskMedicare populationReadmissionElderly populationMedicare beneficiariesHospitalizationClinical servicesFirst monthProlonged riskDeathLongitudinal outcomesAssociation 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 Act
2016
Impact of Exercise Programs on Hospital Readmission Following Hospitalization for Heart Failure: A Systematic Review
Goyal P, Delgado D, Hummel SL, Dharmarajan K. Impact of Exercise Programs on Hospital Readmission Following Hospitalization for Heart Failure: A Systematic Review. Current Cardiovascular Risk Reports 2016, 10: 33. PMID: 28713480, PMCID: PMC5507625, DOI: 10.1007/s12170-016-0514-5.Peer-Reviewed Original ResearchHeart failureExercise programReadmission ratesSystematic reviewAmbulatory heart failure patientsReadmission Following HospitalizationHeart failure hospitalizationHeart failure patientsWiley Cochrane LibraryPre-defined criteriaFailure hospitalizationExercise interventionFailure patientsHospital readmissionHospitalization ratesCochrane LibraryPrincipal diagnosisOvid MEDLINEInclusion criteriaOutpatient facilitiesHigh riskMetropolitan hospitalExercise frequencyPatientsDetection bias
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 declineWomenSubgroupsReadmissions After Carotid Artery Revascularization in the Medicare Population
Al-Damluji MS, Dharmarajan K, Zhang W, Geary LL, Stilp E, Dardik A, Mena-Hurtado C, Curtis JP. Readmissions After Carotid Artery Revascularization in the Medicare Population. Journal Of The American College Of Cardiology 2015, 65: 1398-1408. PMID: 25857904, PMCID: PMC4403264, DOI: 10.1016/j.jacc.2015.01.048.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesCarotid artery stentingHospital risk-standardized readmission ratesCarotid revascularizationCarotid endarterectomyReadmission ratesHospital variationReadmission riskService administrative claims dataKaplan-Meier survival curvesLogistic regressionCarotid artery revascularizationPrior clinical researchAcute care hospitalizationDays of dischargeHospital-level variationSevere carotid stenosisCause hospital readmissionAdministrative claims dataMixed-effects logistic regressionChoice of procedureArtery revascularizationIschemic strokeArtery stentingHospital readmission