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 associationsRelationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure
Wang Y, Eldridge N, Metersky M, Rodrick D, Eckenrode S, Mathew J, Galusha D, Peterson A, Hunt D, Normand S, Krumholz H. Relationship Between In-Hospital Adverse Events and Hospital Performance on 30-Day All-cause Mortality and Readmission for Patients With Heart Failure. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009573. PMID: 37463255, PMCID: PMC10351904, DOI: 10.1161/circoutcomes.122.009573.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesHeart FailureHospital MortalityHospitalsHumansMedicarePatient ReadmissionUnited StatesConceptsMore adverse eventsAdverse eventsHeart failureCause mortalityReadmission ratesHigh riskMedicare Patient Safety Monitoring SystemHospital-acquired adverse eventsIn-Hospital Adverse EventsHospital adverse eventsRate of patientsPatient Safety DatabasePerformance categoriesAdverse event dataCross-sectional studyUnited States CentersHospital performanceHospital characteristicsReadmission dataPatient riskMAIN OUTCOMEPatientsWorst hospitalsHospitalHigh mortality
2021
Trends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States
Mori M, Gupta A, Wang Y, Vahl T, Nazif T, Kirtane AJ, George I, Yong CM, Onuma O, Kodali S, Geirsson A, Leon MB, Krumholz HM. Trends in Transcatheter and Surgical Aortic Valve Replacement Among Older Adults in the United States. Journal Of The American College Of Cardiology 2021, 78: 2161-2172. PMID: 34823659, DOI: 10.1016/j.jacc.2021.09.855.Peer-Reviewed Original ResearchChanges in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
Zhou T, Li X, Lu Y, Murugiah K, Bai X, Hu S, Gao Y, Masoudi FA, Krumholz HM, Li J, . Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015. Open Heart 2021, 8: e001666. PMID: 34599073, PMCID: PMC8488733, DOI: 10.1136/openhrt-2021-001666.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionPrehospital delayMyocardial infarctionSegment elevation myocardial infarctionProportion of patientsElevation myocardial infarctionAcute cardiovascular careAcute myocardial infarctionWeighted national estimateHealth service capacityRisk-adjusted ratesAcute reperfusionEligible patientsHospital deathReperfusion therapyMedical chartsPatient characteristicsHospital treatmentPatient outcomesRandom cohortCardiovascular diseaseCardiovascular carePatientsNational estimatesStandardised definitionsAssociation of COVID-19 Hospitalization Volume and Case Growth at US Hospitals with Patient Outcomes
Khera R, Liu Y, de Lemos JA, Das SR, Pandey A, Omar W, Kumbhani DJ, Girotra S, Yeh RW, Rutan C, Walchok J, Lin Z, Bradley SM, Velazquez EJ, Churchwell KB, Nallamothu BK, Krumholz HM, Curtis JP. Association of COVID-19 Hospitalization Volume and Case Growth at US Hospitals with Patient Outcomes. The American Journal Of Medicine 2021, 134: 1380-1388.e3. PMID: 34343515, PMCID: PMC8325555, DOI: 10.1016/j.amjmed.2021.06.034.Peer-Reviewed Original ResearchConceptsCOVID-19 hospitalizationHospitalization volumeAmerican Heart Association COVID-19 Cardiovascular Disease RegistryCase volumeUS hospitalsCoronavirus disease 2019 (COVID-19) hospitalizationIntensive care unit therapyHospital case fatality ratePoor COVID-19 outcomesCardiovascular Disease RegistryHospital case volumeCase fatality rateCOVID-19 outcomesHospital bed capacityLowest quartilePatient outcomesHospital careHigher oddsTriage strategiesFuture health challengesDisease RegistryMedical treatmentEarly identificationHospitalSignificant associationUse of Machine Learning Models to Predict Death After Acute Myocardial Infarction
Khera R, Haimovich J, Hurley NC, McNamara R, Spertus JA, Desai N, Rumsfeld JS, Masoudi FA, Huang C, Normand SL, Mortazavi BJ, Krumholz HM. Use of Machine Learning Models to Predict Death After Acute Myocardial Infarction. JAMA Cardiology 2021, 6: 633-641. PMID: 33688915, PMCID: PMC7948114, DOI: 10.1001/jamacardio.2021.0122.Peer-Reviewed Original ResearchMeSH KeywordsAgedCohort StudiesFemaleHospital MortalityHumansMachine LearningMaleMyocardial InfarctionRegistriesRisk AssessmentUnited StatesConceptsMachine learning modelsMeta-classifier modelLearning modelNeural networkGradient descent boostingAcute myocardial infarctionContemporary machineGradient descentXGBoost modelXGBoostHospital mortalityCohort studyLogistic regressionMyocardial infarctionNetworkChest Pain-MI RegistryPrecise classificationIndependent validation dataInitial laboratory valuesNovel methodLarge national registryHigh-risk individualsData analysisValidation dataResolution of riskClinical 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 populationAssociation between antecedent statin use and decreased mortality in hospitalized patients with COVID-19
Gupta A, Madhavan MV, Poterucha TJ, DeFilippis EM, Hennessey JA, Redfors B, Eckhardt C, Bikdeli B, Platt J, Nalbandian A, Elias P, Cummings MJ, Nouri SN, Lawlor M, Ranard LS, Li J, Boyle C, Givens R, Brodie D, Krumholz HM, Stone GW, Sethi SS, Burkhoff D, Uriel N, Schwartz A, Leon MB, Kirtane AJ, Wan EY, Parikh SA. Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19. Nature Communications 2021, 12: 1325. PMID: 33637713, PMCID: PMC7910606, DOI: 10.1038/s41467-021-21553-1.Peer-Reviewed Original ResearchConceptsAcute respiratory distress syndromeStatin usePrimary endpointCOVID-19Multivariable logistic regression modelStudy periodLower inpatient mortalityPropensity-matched cohortRespiratory distress syndromeCoronavirus disease 2019Electronic medical recordsLogistic regression modelsPropensity-score matchingHospital mortalityHyperinflammatory stateOutpatient medicationsClinical characteristicsInpatient mortalityStatin usersThrombotic complicationsDistress syndromeHospitalized patientsMyocardial injuryMedical recordsRetrospective analysisAssociation of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19
Khera R, Clark C, Lu Y, Guo Y, Ren S, Truax B, Spatz ES, Murugiah K, Lin Z, Omer SB, Vojta D, Krumholz HM. Association of Angiotensin‐Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death in Hypertensive Patients with Coronavirus Disease‐19. Journal Of The American Heart Association 2021, 10: e018086. PMID: 33624516, PMCID: PMC8403305, DOI: 10.1161/jaha.120.018086.Peer-Reviewed Original ResearchConceptsAngiotensin receptor blockersLower hospitalization riskACE inhibitorsCOVID-19 hospitalizationHospitalization riskHospital mortalityReceptor blockersValidation cohortAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionEnzyme inhibitorsSyndrome coronavirus 2 infectionAngiotensin converting enzyme (ACE) inhibitorsCoronavirus 2 infectionRisk of hospitalizationCoronavirus disease-19SARS-CoV-2COVID-19 preventionHypertensive patientsInpatient cohortOutpatient cohortContemporary cohortStudy cohortOutpatient studyMedicare groupAdministrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery
Mori M, Nasir K, Bao H, Jimenez A, Legore SS, Wang Y, Grady J, Lama SD, Brandi N, Lin Z, Kurlansky P, Geirsson A, Bernheim SM, Krumholz HM, Suter LG. Administrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery. Circulation Cardiovascular Quality And Outcomes 2021, 14: e006644. PMID: 33535776, DOI: 10.1161/circoutcomes.120.006644.Peer-Reviewed Original ResearchMeSH KeywordsAgedCoronary Artery BypassHospital MortalityHospitalsHumansMedicarePatient ReadmissionUnited StatesConceptsRisk-standardized mortality ratesCoronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryMortality rateGraft surgeryC-statisticMedicaid ServicesAdministrative Claims MeasureCause mortality ratesMortality measuresUnadjusted mortality ratesProfiling Hospital PerformanceHierarchical logistic regression modelsAlternate payment modelsHospital performanceLogistic regression modelsCABG recoveryPayment modelsCABG surgeryCause mortalityCABG proceduresDays postsurgeryHospital levelSurgery
2020
Geographic Variation in Process and Outcomes of Care for Patients With Acute Myocardial Infarction in China From 2001 to 2015
Zhong Q, Gao Y, Zheng X, Chen J, Masoudi FA, Lu Y, Feng Y, Hu S, Zhang Q, Huang C, Wang Y, Krumholz HM, Li X, Zhou Y. Geographic Variation in Process and Outcomes of Care for Patients With Acute Myocardial Infarction in China From 2001 to 2015. JAMA Network Open 2020, 3: e2021182. PMID: 33095248, PMCID: PMC7584924, DOI: 10.1001/jamanetworkopen.2020.21182.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionProcess of careHospital mortalityMyocardial infarctionOdds ratioAngiotensin receptor blockersCross-sectional studyOutcomes of careReceptor blockersReperfusion therapyPatient characteristicsTherapy useCare measuresPatient hospitalizationIdeal patientOutcome measuresMAIN OUTCOMEΒ-blockersAMI managementPatientsEnzyme inhibitorsSignificant geographic variationMortalityCareHospitalizationRevascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018
Khera R, Secemsky EA, Wang Y, Desai NR, Krumholz HM, Maddox TM, Shunk KA, Virani SS, Bhatt DL, Curtis J, Yeh RW. Revascularization Practices and Outcomes in Patients With Multivessel Coronary Artery Disease Who Presented With Acute Myocardial Infarction and Cardiogenic Shock in the US, 2009-2018. JAMA Internal Medicine 2020, 180: 1317-1327. PMID: 32833024, PMCID: PMC9377424, DOI: 10.1001/jamainternmed.2020.3276.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCohort StudiesCoronary VesselsFemaleFollow-Up StudiesHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionPatient DischargePercutaneous Coronary InterventionRisk AssessmentRisk FactorsShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTreatment OutcomeUnited StatesConceptsST-segment elevation myocardial infarctionMultivessel percutaneous coronary interventionMultivessel coronary artery diseasePercutaneous coronary interventionAcute myocardial infarctionCoronary artery diseaseCulprit vessel percutaneous coronary interventionCardiogenic shockHospital mortalityArtery diseaseMyocardial infarctionCohort studyPrimary outcomeHospital variationPCI strategyMedicare beneficiariesUnderwent multivessel PCISignificant hospital variationElevation myocardial infarctionSubset of patientsHigh-risk populationRecent evidenceHospital complicationsPCI useRevascularization practiceAssociation of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock
Dhruva SS, Ross JS, Mortazavi BJ, Hurley NC, Krumholz HM, Curtis JP, Berkowitz A, Masoudi FA, Messenger JC, Parzynski CS, Ngufor C, Girotra S, Amin AP, Shah ND, Desai NR. Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock. JAMA 2020, 323: 734-745. PMID: 32040163, PMCID: PMC7042879, DOI: 10.1001/jama.2020.0254.Peer-Reviewed Original ResearchMeSH KeywordsAgedCause of DeathExtracorporeal Membrane OxygenationFemaleHeart ArrestHeart-Assist DevicesHemorrhageHospital MortalityHumansIntra-Aortic Balloon PumpingMaleMatched-Pair AnalysisMiddle AgedMyocardial InfarctionPercutaneous Coronary InterventionPropensity ScoreRegistriesRetrospective StudiesShock, CardiogenicST Elevation Myocardial InfarctionConceptsMicroaxial left ventricular assist deviceIntra-aortic balloon pumpLeft ventricular assist deviceAcute myocardial infarctionPercutaneous coronary interventionNational Cardiovascular Data RegistryCardiogenic shockHemodynamic supportMyocardial infarctionRegistry-based retrospective cohort studyCardiology-National Cardiovascular Data RegistryChest Pain-MI RegistryST-elevation myocardial infarctionMechanical circulatory support devicesGreater hemodynamic supportHospital major bleedingRetrospective cohort studyPropensity-matched pairsCirculatory support devicesVentricular assist deviceClinical laboratory dataHospital mortalityMajor bleedingHospital deathCohort study
2019
The relationship between off-hours admissions for primary percutaneous coronary intervention, door-to-balloon time and mortality for patients with ST-elevation myocardial infarction in England: a registry-based prospective national cohort study
Jayawardana S, Salas-Vega S, Cornehl F, Krumholz HM, Mossialos E. The relationship between off-hours admissions for primary percutaneous coronary intervention, door-to-balloon time and mortality for patients with ST-elevation myocardial infarction in England: a registry-based prospective national cohort study. BMJ Quality & Safety 2019, 29: 541-549. PMID: 31831635, PMCID: PMC7362773, DOI: 10.1136/bmjqs-2019-010067.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionOff-hours admissionPercutaneous coronary interventionDTB timeCoronary interventionBalloon timeST-elevation myocardial infarction (STEMI) patientsElevation myocardial infarction patientsProspective national cohort studyST-elevation myocardial infarctionCent of admissionsMedian DTB timeOff-hour effectPatient risk factorsProspective observational studyRecords of patientsPrimary outcome measureNational cohort studyTimeliness of careMyocardial infarction patientsHierarchical logistic regression modelsLogistic regression modelsHospital mortalityCohort studySecondary outcomesUsefulness 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 adultsCharacteristics, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: The China PEACE Retrospective Heart Failure Study
Yu Y, Gupta A, Wu C, Masoudi FA, Du X, Zhang J, Krumholz HM, Li J, Group T. Characteristics, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: The China PEACE Retrospective Heart Failure Study. Journal Of The American Heart Association 2019, 8: e012884. PMID: 31431117, PMCID: PMC6755852, DOI: 10.1161/jaha.119.012884.Peer-Reviewed Original ResearchConceptsHeart failureHF careSignificant healthcare resource utilizationBackground Heart failureGuideline-recommended medicationsLower inpatient mortalityAcute heart failureOutcomes of patientsHealthcare resource utilizationLower prescription ratesMedical record abstractionHeart Failure StudyTraditional Chinese medicineHospital mortalityConclusions PatientsInpatient mortalityPatient characteristicsTreatment withdrawalEjection fractionMedian agePrescription ratesRecord abstractionMedian lengthBiomarker testingInpatient settingComparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data
Krumholz HM, Coppi AC, Warner F, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Lin Z, Normand ST. Comparative Effectiveness of New Approaches to Improve Mortality Risk Models From Medicare Claims Data. JAMA Network Open 2019, 2: e197314. PMID: 31314120, PMCID: PMC6647547, DOI: 10.1001/jamanetworkopen.2019.7314.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionICD-9-CM codesMortality risk modelHeart failureHospital admissionC-statisticMAIN OUTCOMEMortality rateRisk-standardized mortality ratesHospital risk-standardized mortality ratesIndex admission diagnosisPatients 65 yearsDays of hospitalizationComparative effectiveness studiesClaims-based dataHospital-level performance measuresMedicare claims dataPatient-level modelsCMS modelRisk-adjustment modelsRisk modelHospital performance measuresAdmission diagnosisNinth RevisionMyocardial infarctionAcute 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 indexAssociation Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest
Khera R, Tang Y, Link MS, Krumholz HM, Girotra S, Chan PS. Association Between Hospital Recognition for Resuscitation Guideline Adherence and Rates of Survival for In-Hospital Cardiac Arrest. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005429. PMID: 30871337, PMCID: PMC6592630, DOI: 10.1161/circoutcomes.118.005429.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAwards and PrizesFemaleGuideline AdherenceHeart ArrestHospital MortalityHospitalsHumansInpatientsMaleMiddle AgedOutcome and Process Assessment, Health CarePatient DischargePractice Guidelines as TopicPractice Patterns, Physicians'Quality Indicators, Health CareRegistriesResuscitationTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesYoung AdultConceptsHospital cardiac arrestCardiac arrestRate of survivalSpontaneous circulationIn-Hospital Cardiac ArrestGuidelines-Resuscitation registryCardiac arrest survivalEndotracheal tube placementHigh rateHospital performanceBest tertileGuidelines-ResuscitationNational GetGuideline adherenceOverall survivalBackground HospitalTube placementNational registryChest compressionsResuscitation qualityHospitalHospital recognitionAward statusSurvivalWeak association
2018
Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014
Angraal S, Khera R, Wang Y, Lu Y, Jean R, Dreyer RP, Geirsson A, Desai NR, Krumholz HM. Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014. Journal Of The American Heart Association 2018, 7: e009014. PMID: 30005557, PMCID: PMC6064835, DOI: 10.1161/jaha.118.009014.Peer-Reviewed Original ResearchConceptsCoronary artery bypassCABG utilizationArtery bypassUse of CABGService Medicare beneficiariesCalendar year trendsCABG mortalityUnderwent CABGReadmission ratesCABG proceduresWhite patientsBlack patientsPatient groupMedicare beneficiariesMedicare feeMortality rateCABGAnnual declineWomenRacial subgroupsRacial differencesGreater declineOutcomesPatientsSex