2023
The association between mental illness and all-cause mortality in patients with cirrhosis: a Veterans Affairs retrospective cohort study
Shaffer L, Kaplan D, Taddei T, Mahmud N. The association between mental illness and all-cause mortality in patients with cirrhosis: a Veterans Affairs retrospective cohort study. Hepatology Communications 2023, 7: e0129. PMID: 36996031, PMCID: PMC10069831, DOI: 10.1097/hc9.0000000000000129.Peer-Reviewed Original ResearchConceptsMental health diagnosesAUD/SUDCause mortalityMental health visitsRetrospective cohort studyCohort studyHealth diagnosisHealth visitsSUD diagnosisMental illnessMental health clinic visitsMental health-related diagnosisOutpatient mental health visitsOutpatient mental health careVeterans Health AdministrationHealth-related careHealth-related diagnosesClinical practice changesHealth clinic visitsMental health careClinic visitsClinic utilizationCox regressionPsychiatric comorbiditySubgroup analysis
2022
The Association Between Proton Pump Inhibitor Exposure and Key Liver-Related Outcomes in Patients With Cirrhosis: A Veterans Affairs Cohort Study
Mahmud N, Serper M, Taddei TH, Kaplan DE. The Association Between Proton Pump Inhibitor Exposure and Key Liver-Related Outcomes in Patients With Cirrhosis: A Veterans Affairs Cohort Study. Gastroenterology 2022, 163: 257-269.e6. PMID: 35398042, PMCID: PMC10020994, DOI: 10.1053/j.gastro.2022.03.052.Peer-Reviewed Original ResearchConceptsLiver-related mortalityPPI exposureGastrointestinal bleedingCause mortalityProton pump inhibitor exposurePrior gastrointestinal bleedingTime-updated variablesCause-specific mortality analysesLarge national cohortVeterans Health AdministrationRisk of infectionCardiovascular comorbiditiesPPI useCohort studyStatin exposureCox regressionRetrospective studyAdverse outcomesAppropriate indicationsNational cohortInhibitor exposureSevere infectionsCirrhosis diagnosisAdditional adjustmentAdjusted modelStatin exposure is associated with reduced development of acute-on-chronic liver failure in a Veterans Affairs cohort
Mahmud N, Chapin S, Goldberg DS, Reddy KR, Taddei TH, Kaplan DE. Statin exposure is associated with reduced development of acute-on-chronic liver failure in a Veterans Affairs cohort. Journal Of Hepatology 2022, 76: 1100-1108. PMID: 35066085, PMCID: PMC9018495, DOI: 10.1016/j.jhep.2021.12.034.Peer-Reviewed Original ResearchConceptsChronic liver failureStatin exposureLiver failureStatin useCohort studyChronic liver failure developmentInverse probability treatment weightingProportional hazards regression modelsDoses of statinsVeterans Affairs cohortRetrospective cohort studyChronic liver diseaseHazards regression modelsLarge national cohortVeterans Health AdministrationNumerous beneficial effectsMarginal structural modelsMedian followStatin therapyLiver diseaseNational cohortACLFTreatment weightingCirrhosisPatients
2021
Association of BNT162b2 mRNA and mRNA-1273 Vaccines With COVID-19 Infection and Hospitalization Among Patients With Cirrhosis
John BV, Deng Y, Scheinberg A, Mahmud N, Taddei TH, Kaplan D, Labrada M, Baracco G, Dahman B. Association of BNT162b2 mRNA and mRNA-1273 Vaccines With COVID-19 Infection and Hospitalization Among Patients With Cirrhosis. JAMA Internal Medicine 2021, 181: 1306-1314. PMID: 34254978, PMCID: PMC8278308, DOI: 10.1001/jamainternmed.2021.4325.Peer-Reviewed Original ResearchConceptsCOVID-19 infectionCOVID-19-related hospitalizationBNT162b2 mRNAFirst doseCohort studySecond doseMRNA vaccinesClinical trialsControl groupPropensity-matched control groupPhase 3 clinical trialsCOVID-19 mRNA vaccinesAssociation of vaccinationRetrospective cohort studyUS veteran populationAssociation of receiptVeterans Health AdministrationCoronavirus disease 2019COVID-19 hospitalizationMRNA vaccine administrationCOVID-19Vaccine recipientsImmune dysregulationModerna mRNAMedian ageImpact of SGLT2 inhibitors in comparison with DPP4 inhibitors on ascites and death in veterans with cirrhosis on metformin
Saffo S, Kaplan DE, Mahmud N, Serper M, John BV, Ross JS, Taddei T. Impact of SGLT2 inhibitors in comparison with DPP4 inhibitors on ascites and death in veterans with cirrhosis on metformin. Diabetes Obesity And Metabolism 2021, 23: 2402-2408. PMID: 34227216, PMCID: PMC8429193, DOI: 10.1111/dom.14488.Peer-Reviewed Original ResearchConceptsSodium-glucose cotransporter 2 inhibitorsDipeptidyl peptidase-4 inhibitorsPeptidase-4 inhibitorsDiabetes mellitusLiver diseaseNon-alcoholic fatty liver diseaseCotransporter 2 inhibitorsChronic liver diseaseFatty liver diseaseVeterans Affairs hospitalIncidence of ascitesAdditional pharmacotherapyTreat analysisElectronic health dataSGLT2 inhibitorsSGLT2i usersSurrogate biomarkerDPP4 inhibitorsMetabolic effectsPatientsCirrhosisPropensity scoreAscitesConfirmatory studiesMetforminRisk Prediction Models for Postoperative Decompensation and Infection in Patients With Cirrhosis: A Veterans Affairs Cohort Study
Mahmud N, Fricker Z, Lewis JD, Taddei TH, Goldberg DS, Kaplan DE. Risk Prediction Models for Postoperative Decompensation and Infection in Patients With Cirrhosis: A Veterans Affairs Cohort Study. Clinical Gastroenterology And Hepatology 2021, 20: e1121-e1134. PMID: 34246794, PMCID: PMC8741885, DOI: 10.1016/j.cgh.2021.06.050.Peer-Reviewed Original ResearchConceptsLiver diseasePostoperative decompensationPostoperative mortalityPostoperative infectionRisk scoreAlcohol-related liver diseaseEnd-stage liver diseaseMayo risk scoreSurgical risk scoresData of patientsMultivariable logistic regressionVeterans Health AdministrationRange of surgeryRisk prediction modelCirrhosis decompensationPugh scoreChild-TurcottePostoperative complicationsCohort studyPostoperative dayRetrospective studyStratify patientsVeteran outcomesDecompensationExcellent calibrationFactors Associated With Access to and Receipt of Liver Transplantation in Veterans With End-stage Liver Disease
Kanwal F, Hernaez R, Liu Y, Taylor TJ, Rana A, Kramer JR, Naik AD, Smith D, Taddei T, Asch SM. Factors Associated With Access to and Receipt of Liver Transplantation in Veterans With End-stage Liver Disease. JAMA Internal Medicine 2021, 181: 949-959. PMID: 34028505, PMCID: PMC8145153, DOI: 10.1001/jamainternmed.2021.2051.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseAdvanced liver diseaseLiver diseaseLiver transplantationCohort studyMedical recordsOrgan transplantsVeterans Affairs Health Care SystemLower ratesRetrospective cohort studyWait-listed patientsAfrican American patientsComprehensive electronic medical recordsElectronic medical recordsHealth care systemReferral stepsLiver allograftsLiver transplantAdult patientsAlcohol etiologyLow annual incomePatient ageCurative therapyLiver cirrhosisSodium scoreMortality and Hepatic Decompensation in Patients With Cirrhosis and Atrial Fibrillation Treated With Anticoagulation
Serper M, Weinberg EM, Cohen JB, Reese PP, Taddei TH, Kaplan DE. Mortality and Hepatic Decompensation in Patients With Cirrhosis and Atrial Fibrillation Treated With Anticoagulation. Hepatology 2021, 73: 219-232. PMID: 32267547, PMCID: PMC7541418, DOI: 10.1002/hep.31264.Peer-Reviewed Original ResearchConceptsDirect oral anticoagulantsEffect of anticoagulationAtrial fibrillationCause mortalityMarginal structural modelsHepatic decompensationIschemic strokeMajor adverse cardiovascular eventsAdvanced liver diseaseAdverse cardiovascular eventsIncident atrial fibrillationSplanchnic vein thrombosisPropensity-score matchingCardiovascular eventsOral anticoagulantsVein thrombosisFinal cohortLiver diseaseTime-dependent confoundingAnticoagulationLower incidenceMedical CenterCirrhosisWarfarinU.S. veterans
2020
Getting to implementation: a protocol for a Hybrid III stepped wedge cluster randomized evaluation of using data-driven implementation strategies to improve cirrhosis care for Veterans
Rogal SS, Yakovchenko V, Morgan T, Bajaj JS, Gonzalez R, Park A, Beste L, Miech EJ, Lamorte C, Neely B, Gibson S, Malone PS, Chartier M, Taddei T, Garcia-Tsao G, Powell BJ, Dominitz JA, Ross D, Chinman MJ. Getting to implementation: a protocol for a Hybrid III stepped wedge cluster randomized evaluation of using data-driven implementation strategies to improve cirrhosis care for Veterans. Implementation Science 2020, 15: 92. PMID: 33087156, PMCID: PMC7579930, DOI: 10.1186/s13012-020-01050-7.Peer-Reviewed Original ResearchConceptsVA Medical CenterCirrhosis careVeterans Health AdministrationEvidence-based practiceImplementation interventionsAim 1Stepped-wedge clusterBackground cirrhosisImplementation strategiesMedical CenterWedge clusterAim 3Health AdministrationEBP uptakeCirrhosisAim 2CareExpert recommendationsSuccessful implementation strategiesInterventionVeteransChange taxonomyImplementation support toolsProgram evaluationSemi-structured interviewsPatterns of COVID-19 testing and mortality by race and ethnicity among United States veterans: A nationwide cohort study
Rentsch CT, Kidwai-Khan F, Tate JP, Park LS, King JT, Skanderson M, Hauser RG, Schultze A, Jarvis CI, Holodniy M, Re V, Akgün KM, Crothers K, Taddei TH, Freiberg MS, Justice AC. Patterns of COVID-19 testing and mortality by race and ethnicity among United States veterans: A nationwide cohort study. PLOS Medicine 2020, 17: e1003379. PMID: 32960880, PMCID: PMC7508372, DOI: 10.1371/journal.pmed.1003379.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBetacoronavirusBlack or African AmericanClinical Laboratory TechniquesCohort StudiesCoronavirus InfectionsCOVID-19COVID-19 TestingEthnicityFemaleHispanic or LatinoHumansMaleMiddle AgedPandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2United StatesVeteransWhite PeopleYoung AdultConceptsCOVID-19 testingRace/ethnicityCohort studyWhite individualsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionAcute respiratory syndrome coronavirus 2 infectionSyndrome coronavirus 2 infectionSARS-CoV-2 infectionCOVID-19Large integrated healthcare systemCoronavirus 2 infectionNationwide cohort studyRetrospective cohort studyCoronavirus disease 2019Site of careIntegrated healthcare systemNon-Hispanic blacksPositive test resultsNon-Hispanic whitesClinical characteristicsMultivariable adjustmentComorbid conditionsMedication historyEthnic minority communitiesDisease 2019Models for acute on chronic liver failure development and mortality in a veterans affairs cohort
Xiao KY, Hubbard RA, Kaplan DE, Taddei TH, Goldberg DS, Mahmud N. Models for acute on chronic liver failure development and mortality in a veterans affairs cohort. Hepatology International 2020, 14: 587-596. PMID: 32519219, PMCID: PMC7656856, DOI: 10.1007/s12072-020-10060-y.Peer-Reviewed Original ResearchConceptsACLF mortalityCompensated cirrhosisChronic liver failure developmentEnd-stage liver diseaseHigh short-term mortalityLarge North American cohortDevelopment of ACLFVeterans Affairs cohortAsian Pacific AssociationChronic liver failureEscalation of careNovel risk prediction modelShort-term mortalityMultivariable logistic regressionNorth American cohortRisk prediction modelGood discriminationACLF developmentACLF patientsACLF scoreLiver (APASL) definitionsMELD-sodiumTransplant evaluationRisk patientsCirrhosis patients
2019
Quality Measures, All‐Cause Mortality, and Health Care Use in a National Cohort of Veterans With Cirrhosis
Serper M, Kaplan DE, Shults J, Reese PP, Beste LA, Taddei TH, Werner RM. Quality Measures, All‐Cause Mortality, and Health Care Use in a National Cohort of Veterans With Cirrhosis. Hepatology 2019, 70: 2062-2074. PMID: 31107967, PMCID: PMC6864236, DOI: 10.1002/hep.30779.Peer-Reviewed Original ResearchConceptsHealth care useHepatocellular carcinoma surveillanceCause mortalityCare useVariceal surveillanceQuality improvement effortsPostdischarge careNational cohortSpecialty careOutpatient accessFuture quality improvement effortsLiver disease cohortUpper gastrointestinal bleedingLarge national cohortGastrointestinal bleedingMean followAdjusted analysisHigh morbidityRetrospective studyDomains of accessVeteran outcomesStandardized quality measuresInpatient careDisease cohortHigh adherenceHIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status
Torgersen J, Kallan MJ, Carbonari DM, Park LS, Mehta RL, D’Addeo K, Tate JP, Lim JK, Goetz MB, Rodriguez-Barradas MC, Gibert CL, Bräu N, Brown ST, Roy JA, Taddei TH, Justice AC, Re V. HIV RNA, CD4+ Percentage, and Risk of Hepatocellular Carcinoma by Cirrhosis Status. Journal Of The National Cancer Institute 2019, 112: 747-755. PMID: 31687755, PMCID: PMC7357318, DOI: 10.1093/jnci/djz214.Peer-Reviewed Original ResearchConceptsRisk of HCCHigher HIV RNAHCC risk factorsHIV RNAHIV viremiaHepatocellular carcinomaBaseline cirrhosisCirrhosis statusCohort studyRisk factorsCell percentageVeterans Aging Cohort StudyDevelopment of HCCCurrent HIV RNADetectable HIV viremiaHepatitis C coinfectionAging Cohort StudyDiagnosis of cirrhosisLonger durationDetectable HIVLow CD4C coinfectionCurrent CD4Hazard ratioCancer RegistryRegional and Rural-Urban Differences in the Use of Direct-acting Antiviral Agents for Hepatitis C Virus
Njei B, Esserman D, Krishnan S, Ohl M, Tate JP, Hauser RG, Taddei T, Lim J, Justice AC. Regional and Rural-Urban Differences in the Use of Direct-acting Antiviral Agents for Hepatitis C Virus. Medical Care 2019, 57: 279-285. PMID: 30807449, PMCID: PMC6436819, DOI: 10.1097/mlr.0000000000001071.Peer-Reviewed Original ResearchConceptsDirect-acting antiviral agentsHepatitis C virus infectionVeterans Affairs Healthcare SystemRural-Urban Commuting Area codesCurative HCV treatmentRural-urban designationC virus infectionElectronic health record dataHepatitis C virusPrior treatment experienceLower odds ratioHealth record dataZone improvement plan codeEligible patientsHCV treatmentAntiretroviral medicationsRural-urban residenceLiver diseaseUnadjusted analysesC virusRural-urban differencesOdds ratioMultivariable modelLower incidenceObservational study
2017
Healthcare Costs Related to Treatment of Hepatocellular Carcinoma Among Veterans With Cirrhosis in the United States
Kaplan DE, Chapko MK, Mehta R, Dai F, Skanderson M, Aytaman A, Baytarian M, D’Addeo K, Fox R, Hunt K, Pocha C, Valderrama A, Taddei TH, Group V. Healthcare Costs Related to Treatment of Hepatocellular Carcinoma Among Veterans With Cirrhosis in the United States. Clinical Gastroenterology And Hepatology 2017, 16: 106-114.e5. PMID: 28756056, PMCID: PMC5735018, DOI: 10.1016/j.cgh.2017.07.024.Peer-Reviewed Original ResearchConceptsMultivariable generalized linear modelsMultidisciplinary tumor boardHepatocellular carcinomaIntegrated health systemCancer-related costsHealthcare costsLiver transplantationBCLC stageLiver diseaseTumor boardBarcelona Clinic Liver Cancer stageVeterans Affairs Corporate Data WarehouseHealth systemCases of HCCBasis of receiptLiver disease cohortReceipt of transplantationLiver disease etiologyChronic liver diseaseLiver Cancer stageLiver cancer surveillanceBasis of severityHospital academic affiliationCorporate Data WarehouseCirrhosis controls
2016
Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis
Kaplan DE, Dai F, Skanderson M, Aytaman A, Baytarian M, D’Addeo K, Fox R, Hunt K, Knott A, Mehta R, Pedrosa M, Pocha C, Valderrama A, Taddei T, for the VOCAL Study Group. Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis. Digestive Diseases And Sciences 2016, 61: 3309-3320. PMID: 27405990, PMCID: PMC5067291, DOI: 10.1007/s10620-016-4239-6.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBilirubinCreatinineDisease ProgressionEnd Stage Liver DiseaseEvidence-Based MedicineFemaleHumansInternational Normalized RatioLiver CirrhosisLiver TransplantationMaleMiddle AgedOdds RatioPrognosisProportional Hazards ModelsRetrospective StudiesSerum AlbuminSeverity of Illness IndexUnited StatesVeteransConceptsTransplant-free survivalHarrell's C-statisticC-statisticPugh scoreChild-TurcotteCTP scoreHighest Harrell's C-statisticsCox proportional hazards modelEvidence-based cutpointProportional hazards modelLong-term survivalEtiology subgroupsSerum creatinineVeteran patientsLaboratory variablesRisk ratioTotal bilirubinHazards modelCirrhosisPatientsLower cutpointsDisease etiologySurvivalCutpointsScores